PREDICTIVE VALUE OF C-REACTIVE PROTEIN/ALBUMİN RATIO IN THE DEVELOPMENT OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS WITH ACUTE ISCHEMIC STROKE TREATED PERCUTANEOUSLY

Year 2022, Volume: 10 Issue: 1, 130 - 139, 10.03.2022

Erdoğan Yaşar

https://doi.org/10.33715/inonusaglik.1028554

Cited By: 1

Abstract

Contrast induced nephropathy (CIN) is known to play an important role in acute kidney injury. The purpose of this study was to determine the predictive effect of the CRP/albumin ratio (CAR) in the detection of CIN in patients with acute ischemic stroke (AIS) treated percutaneously. A total of 148 acute stroke patients treated percutaneously were included in the study. In the study population, groups were determined according to the development of CIN. The CAR value was calculated by dividing the CRP value by the albumin value. CIN developed in 26 (17%) patients. DM (p=0.031) and HT (p=0.014) diseases were observed at higher rate in the CIN group. Glucose (p<0.001), contrast amount (p<0.001), WBC (p=0.020), NIHSS0 score (p=0.001), and CAR (p<0.001) were higher in the CIN (+) group compared to the CIN (-) group. A cutoff point of 0.393 for CAR was identified with 80.7% sensitivity and 92.6% specificity to predict CIN. The CAR was found to be significantly higher in CIN patients and was also identified as an independent predictor of the development of CIN.

Keywords

Acute ischemic stroke, C-reactive protein to albumin ratio, Contrast induced nephropathy

Thanks

I would like to thank Dr Yahya Akalın from the Neurology Department of Malatya Training and Research Hospital for his support.

Perkutan Olarak Tedavi Edilen Akut İskemik İnme’li Hastalarda Kontrast Kaynaklı Nefropati Gelişiminde C-Reaktif Protein /Albumin Oranının Öngörü Değeri

Abstract

Kontrast kaynaklı nefropatinin (KKN) akut böbrek hasarında önemli rolü olduğu bilinmektedir. Çalışmamızda, perkütan olarak tedavi edilen akut iskemik inmeli hastalarda KKN tespitinde CRP/albümin oranının (CAO) tahmin edici etkisini ortaya koymak amaçlanmıştır. Perkütan olarak tedavi edilen toplam 148 akut inme hastası çalışmaya dahil edilmiştir. Çalışma popülasyonunda gruplar KKN gelişimine göre iki gruba ayrıldı. CAO değeri, CRP değerinin albümin değerine bölünmesiyle elde edildi. 26 (%17) hastada KKN gelişti. DM (p=0.031) ve HT (p=0.014) hastalıkları KKN grubunda daha yüksek oranda izlendi. Glikoz (p<0.001), kontrast miktarı (p<0.001), WBC (p=0.020), NIHSS0 skoru (p=0.001) ve CAO (p<0.001) KKN (+) grubunda KKN (-)'e göre daha yüksekti. CAO için 0,393'lük bir eşik değeri, KKN'yi tahmin etmek için %80.7 duyarlılık ve %92.6 özgüllük ile belirlendi. CAO, KKN hastalarında anlamlı olarak daha yüksek bulundu ve ayrıca KKN gelişiminin bağımsız bir öngörücüsü olarak tanımlandı.

Keywords

Akut iskemik inme, C-reaktif protein/albümin oranı, Kontrast kaynaklı nefropati

References

• American Diabetes Association. (2014). Diagnosis and classification ofbdiabetes mellitus. Diabetes Care, 37, 81-90.
• Aşkın, L., Tanrıverdi, O., Tibilli, H., Türkmen, S. (2019). Prognostic value of C-reactive protein/ albumin ratio in ST-segment elevation myocardial infarction. Interventional Medicine & Applied Science,11 (3), 168–171.
• Barber, P. A., Demchuk, A. M., Zhang, J., Buchan, A. M. (2000). Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECT study group. Alberta Stroke Programme Early CT Score. Lancet, 355, 1670.
• Barber, P. A., Hill, M. D., Eliasziw, M., Demchuk, A. M., Pexman, J. H. W., Hudon, M. E., …Buchan, A. M. (2005). Imaging of the brain in acute ischaemic stroke: comparison of computed tomography and magnetic resonance diffusion-weighted imaging. J Neurology, Neurosurgery & Psychiatry, 76, 1528.
• Connolly, M., McEneaney, D., Menown, I., Morgan, N., Harbinson, M. (2015). Novel biomarkers of acute kidney injury after contrast coronary angiography. Cardiol Rev, 23, 240-246.
• Çınar, T., Çağdaş, M., Rencüzoğulları, İ., Karakoyun, S., Karabağ, Y., Yesin, M, …Tanboğa Hİ. (2019). Prognostic efficacy of C-reactive protein/albumin ratio in ST elevation myocardial infarction. Scand Cardiovasc J, 53(2), 83-90.
• Finn, W. F. (2006). The clinical and renal consequences of contrast-induced nephropathy. Nephrology Dialysis Transplantation, 21, i2–i10.
• Gao, F., Zhou, Y. J., Zhu, X., Wang, Z. J., Yang, S. W., Shen, H. (2011). C-reactive protein and the risk of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. Am J Nephrol, 34(3), 203–210.
• Hojs, R., Bevc, S., Ekart, R., Gorenjak, M., Puklavec, L. (2011). Kidney function estimating equations in patients with chronic kidney disease. Int J Clin Pract, 65, 458-464.
• Joles, J. A., Willekes-Koolschijn, N., Koomans, H. A. (1997). Hypoalbuminemia causes high blood viscosity by increasing red cell lysophosphatidylcholine. Kidney Int, 52(3), 761–770.
• Karabağ, Y., Çağdaş, M., Rencuzoğulları, İ., Karakoyun, S., Artaç, I., İliş, D., …Tanboğa, I. H. (2019). The C-Reactive Protein to Albumin Ratio Predicts Acute Kidney Injury in Patients with ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Heart Lung Circ, 28(11), 1638-1645.
• Kaya, A., Kaya, Y., Topçu, S., Günaydın, Z. Y., Kurt, M., Tanboğa., Aksakal, E. (2014). Neutrophil-to-Lymphocyte Ratio Predicts Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention. Angiology, 65(1),51-56..
• Kocatürk, M., Kocatürk, O. (2019). Assessment of relationship between C-reactive protein to albumin ratio and 90-day mortality in patients with acute ischaemic stroke. Neurol Neurochir Pol. 53(3):205-211.
• Kwasa, E. A., Vinayak, S., Armstrong, R. (2014). The role of inflammationin contrast-induced nephropathy. Br J Radiol, 87, 20130738.
• Li, L., Dai, L., Wang, X., Wang, Y., Luocheng, Z., Chen, M., Wang, H. (2017). Predictive value of the C-reactive protein-to-prealbumin ratio in medical ICU patients. Biomark Med, 11, 329-337.
• Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhmet, M., …Zannad, F. (2014). 2013 ESH/ESC PracticebGuidelines for the Management of Arterial Hypertension. Blood Press, 23, 3-16.
• McCullough, P. A., Wolyn, R., Rocher, L. L., Levin, R. N., O’Neill, W. W. (1997). Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med, 103(5), 368–375.
• Mehran, R., Aymon, E. D., Nikolsky, E., Lasic, Z., Iakovou, I., Fahy, M., …Dangas, G. (2004). A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol, 44,1393–1399.
• Murat, S. N., Kurtul, A., Yarlioglues, M. (2015). Impact of serum albümin levels on contrast-induced acute kidney injury in patients with acute coronary syndromes treated with percutaneous coronary intervention. Angiology, 66, 732-737.
• Parfrey, P. S., Griffiths, S. M., Barrett, B. J., Paul, M. D., Genge, M., Withers, J., …McManamon, PJ. (1989). Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both. A prospective controlled study. N Engl J Med, 320,143.
• Park, J. E., Chung, K. S., Song, J. H., Kim, SY., Kim, E. Y., Jung, J. Y., … Leem, A. Y. (2018). The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients. J Clin Med, 7(10), 333.
• Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., …Tirschwell, D. L. (2019). Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association, Dec, 50(12), e344-e418.
• Ranzani, O. T., Zampieri, F. G., Forte, D. N., Azevedo, L. C., Park, M. (2013). C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One 8, e59321.
• Roche, M., Rondeau, P., Singh, N. R., Tarnus, E., Bourdon, E. (2008). The antioxidant properties of serum albumin. FEBS Lett,582(13),1783–1787.
• Satılmış, S., Karabulut, A. (2020). Value of C-Reactive Protein/Albumin Ratio in Predicting the Development of Contrast-Induced Nephropathy in Patients with Non-ST Elevation Myocardial Infarction. Angiology, 71, 366-371.
• Solomon, R. J., Natarajan, M. K., Doucet, S., Sharma, S. K., Staniloae, C. S., Katholi, R. E., … Moreyra, A. E. (2007). Cardiac Angiography in Renally Impaired Patients (CARE) study: a randomized double-blind trial of contrast-induced nephropathy in patients with chronic kidney disease. Circulation, 115(25), 3189–3196.
• Tsai, C. M., Yu, H. R., Tang, K. S., Huang, Y. H., Kuo, H. C. (2020). C-Reactive Protein to Albumin Ratio for Predicting Coronary Artery Lesions and Intravenous Immunoglobulin Resistance in Kawasaki Disease. Front. Pediatr, 8, 1-8
• Yang, Q., Tong, X., Schieb, L., Vaughan, A., Gillespie, C., Wiltz, J. L., …George, M. G. (2017). Vital signs: recent trends in stroke death rates - United States, 2000-2015.MMWR Morb Mortal Wkly Rep, 66, 933-939.
• Wei, X. L., Wang, F. H., Zhang, D. S., Qui, M. Z., Ren, C., Jin, Y., …Xu, R. H. (2015). A novel inflammation-based prognostic score in esophageal squamous cell carcinoma: the C-reactive protein/albumin ratio. BMC Cancer, 15, 350.