Inferior Vena Cava Collapsibility Index and the Risk of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Abstract

Introduction: The present study aims to investigate the association between contrast-induced nephropathy (CIN) and inferior vena cava collapsibility index (IVC-CI) measured via echocardiography to estimate intravascular volume. Patients and Methods: A total of 100 patients were referred to coronary angiography (CAG). On the day of admission, blood samples were collected, and an echocardiographic evaluation was performed to estimate IVC-CI immediately before CAG. IVC-CI ratios were stratified into three groups (low, mid, high) (<50%, 50-75%, >75%). Creatinine was assessed again at 48 hours following the CAG procedure. The difference between baseline serum creatinine and serum creatinine at 48 hours was calculated as ΔCrea while the difference in GFR was calculated as ΔGFR. Biochemical parameters and CIN ratios were compared between all groups. Results: There were no differences across the groups in terms of procedural characteristics, preprocedural lab parameters, and concomitant medication. ΔCreatinine, ΔGFR, and the incidence of CIN were significantly higher in the high IVC-CI group. Conclusion: Post-procedure incidence of CIN, ΔGFR, and Δcreatinine compared to the pre-procedure values were higher in the high IVC-CI group.

Keywords

• Contrast induced nephropathy
• inferior vena cava collapsibility index
• coronary angiography

References

1. 1. McCullough PA. Contrast-induced acute kidney injury. J Am Coll Cardiol 2008;51(15):1419-28. [Crossref]
2. 2. James MT, Ghali WA, Tonelli M, Faris P, Knudtson ML, Pannu N, Klarenbach SW, Manns BJ, Hemmelgarn BR. Acute kidney injury following coronary angiography is associated with a long-term decline in kidney function. Kidney Int 2010;78(8):803-9. [Crossref]
3. 3. McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F, et al. Epidemiology and prognostic implications of contrast-induced nephropathy. Am J Cardiol 2006;98(6A):5K-13K. [Crossref]
4. 4. Gruberg L, Mintz GS, Mehran R, Gangas G, Lansky AJ, Kent KM, et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol 2000;36(5):1542-8. [Crossref]
5. 5. Thomsen HS. Guidelines for contrast media from the European Society of Urogenital Radiology. AJR Am J Roentgenol 2003;181(6):1463-71. [Crossref]
6. 6. Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, et al. 2014 ESC/EACTS guidelines on myocardial revascularization. Euro Intervention 2015;10(9):1024-94. [Crossref]
7. 7. Stawicki SP, Adkins EJ, Eiferman DS, Evans DC, Ali NA, Njoku C, et al. Prospective evaluation of intravascular volume status in critically ill patients: Does inferior vena cava collapsibility correlate with central venous pressure? J Trauma Acute Care Surg 2014;76(4):956-63. [Crossref]
8. 8. Stawicki SP, Braslow BM, Panebianco NL, Kirkpatrick JN, Gracias VH, Hayden GE, et al. Intensivist use of hand-carried ultrasonography to measure IVC collapsibility in estimating intravascular volume status: correlations with CVP. J Am Coll Surg 2009;209(1):55-61. [Crossref]

9. 9. Brennan JM, Blair JE, Goonewardena S, Ronan A, Shah D, Vasaiwala S, et al. Reappraisal of the use of inferior vena cava for estimating right atrial pressure. J Am Soc Echocardiogr 2007;20(7):857-61. [Crossref]
10. 10. Briguori C, Condorelli G. Hydration in contrast-induced acute kidney injury. Lancet 2014;383(9931):1786-8. [Crossref]
11. 11. Schilp J, de Blok C, Langelaan M, Spreeuwenberg P, Wagner C. Guideline adherence for identification and hydration of high-risk hospital patients for contrast-induced nephropathy. BMC Nephrol 2014;15:2. [Crossref]
12. 12. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16(1):31-41. [Crossref]
13. 13. McCullough PA, Soman SS. Contrast-induced nephropathy. Crit Care Clin 2005;21(2):261-80. [Crossref]
14. 14. Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: Development and initial validation. J Am Coll Cardiol 2004;44(7):1393-9. [Crossref]
15. 15. Maeder M, Klein M, Fehr T, Rickli H. Contrast nephropathy: Review focusing on prevention J Am Coll Cardiol 2004;44(9):1763-71. [Crossref]
16. 16. McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F, et al. Risk prediction of contrast-induced nephropathy. Am J Cardiol 2006;98(6A):27K-36K. [Crossref]
17. 17. Owen RJ, Hiremath S, Myers A, Fraser-Hill M, Barrett BJ. Canadian Association of Radiologists consensus guidelines for the prevention of contrast-induced nephropathy: Update 2012. Can Assoc Radiol J 2014;65(2):96-105. [Crossref]
18. 18. Persson PB, Hansell P, Liss P. Pathophysiology of contrast medium-induced nephropathy. Kidney Int 2005;68(1):14-22. [Crossref]
19. 19. Keaney JJ, Hannon CM, Murray PT. Contrast-induced acute kidney injury: How much contrast is safe? Nephrol Dial Transplant 2013;28(6):1376-83. [Crossref]
20. 20. Marenzi G, De Metrio M, Rubino M, Lauri G, Cavallero A, Assanelli E, et al. Acute hyperglycemia and contrast-induced nephropathy in primary percutaneous coronary intervention. Am Heart J 2010;160(6):1170-7. [Crossref]
21. 21. Seeliger E, Wronski T, Ladwig M, Dobrowolski L, Vogel T, Godes M, et al. The renin-angiotensin system and the third mechanism of renal blood flow autoregulation. Am J Physiol Renal Physiol 2009;296(6):F1334-45. [Crossref]
22. 22. Seeliger E, Sendeski M, Rihal CS, Persson PB. Contrast-induced kidney injury: Mechanisms, risk factors, and prevention. Eur Heart J 2012;33(16):2007-15. [Crossref]
23. 23. Persson PB, Tepel M. Contrast medium-induced nephropathy: The pathophysiology. Kidney Int Suppl 2006;(100):S8-10. [Crossref]
24. 24. Heyman SN, Rosen S, Khamaisi M, Idée JM, Rosenberger C. Reactive oxygen species and the pathogenesis of radiocontrast-induced nephropathy. Invest Radiol 2010;45(4):188-95. [Crossref]