부산대학교 도서관

Introduction: The incidence of contrast-induced nephropathy (CIN) increases with the progression of renal dysfunction. Therefore, percutaneous coronary intervention (PCI) are frequently avoided in patients with advanced renal dysfunction due to fear of CIN, which may result in poor outcomes. On the other hand, recent reports have shown that PCI can be safely performed even in patients with advanced renal dysfunction by instituting appropriate CIN-prevention strategies. However, data are limited regarding the occurrence and prognostic influence of CIN in patients with advanced renal dysfunction. Methods: We examined the data obtained from 323 consecutive patients with advanced renal dysfunction (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m2) who underwent PCI at 5 hospitals between 2011 and 2016. CIN was defined as a ≥25% increase in baseline serum creatinine levels and/or a ≥0.5 mg/dL increase in absolute serum creatinine levels within 72 h after PCI. Incidence of all-cause death and the initiation of permanent dialysis were examined during follow-up. Results: The prevalence of emergency/urgent PCI was 53.3%. Intravascular ultrasound was used in 266 patients (82.4%), and the volume of contrast used was 71.7±57.2 mL. CIN was observed in 31 patients (9.7%). Patients who developed CIN more commonly presented with shock and pulmonary congestion and received emergency/urgent PCI and had received a greater volume of contrast agent. The median follow-up duration was 656 days (interquartile range 257-1143 days). The cumulative rates of all-cause death or the initiation of permanent dialysis, all-cause death, and the initiation of permanent dialysis were 38.1%, 25.9%, and 18.2%, respectively at 2 years. A comparison between patients with and without CIN showed no significant intergroup differences in the occurrence of the aforementioned events. Conclusions: The development of CIN was not a common occurrence if PCI was performed by instituting appropriate CIN-prevention strategies even in patients with advanced renal dysfunction. The long-term prognosis following PCI is observed to be poor in this studied population. [ABSTRACT FROM AUTHOR]