The predictive role of the CALLY index for contrast-associated acute kidney injury in patients with stable angina pectoris
Öz
Purpose: This study aimed to evaluate the predictive role of the C-reactive protein-albumin-lymphocyte (CALLY) index, which integrates systemic inflammation, nutritional status, and immune response for contrast-associated acute kidney injury in patients undergoing elective coronary angiography. Material and Methods: This retrospective, single-center study included 945 patients who underwent elective coronary angiography for stable angina pectoris between 2020 and 2024. Patients with an ejection fraction <50%, those who required intra-aortic balloon pump support were excluded. Contrast-associated acute kidney injury was defined as an increase in serum creatinine ≥25% or ≥0.5 mg/dL within 72 hours after contrast exposure. Clinical characteristics, laboratory parameters, and the CALLY index were analyzed. Results: Among 945 patients, 332 (35.1%) were female, median age was 58 years. Contrast-associated acute kidney injury developed in 150 patients (15.9%). In the multivariate CALLY-based model, advanced age, diabetes, lower albumin, lower bicarbonate, higher mean corpuscular volume, higher contrast volume and lower CALLY index were independent predictors, while C-reactive protein and uric acid lost significance. Conclusion: The CALLY index independently predicted contrast-associated acute kidney injury but showed modest diagnostic strength. It may serve as a complementary immunonutritional marker rather than a standalone tool. Bicarbonate exhibited the highest diagnostic accuracy, supporting the role of metabolic acidosis in contrast-associated acute kidney injury.
Anahtar Kelimeler
contrast-associated acute kidney injury, coronary angiography, biomarkers, inflammation, nutrition, c-reactive protein
Destekleyen Kurum
Etik Beyan
Teşekkür
Kaynakça
- Lee PH, Huang SM, Tsai YC, Wang YT, Chew FY. Biomarkers in contrast-induced nephropathy: Advances in early detection, risk assessment, and prevention Strategies. Int J Mol Sci. 2025;26:2869.
- Mahapatro A, Nobakht S, Mukesh S, Daryagasht AA, Korsapati AR, Jain SM et al. Evaluating biomarkers for contrast-induced nephropathy following coronary interventions: An umbrella review on meta-analyses. Eur J Med Res. 2024;29:210.
- Mehran R, Nikolsky E. Contrast-induced nephropathy: Definition, epidemiology, and patients at risk. Kidney Int Suppl. 2006;11-5.
- Hasbal NB, Copur S, Siriopol D, Peltek IB, Mutlu A, Cetin BT et al. A survey-based study on attitudes of the clinicians toward contrast-induced nephropathy: Which drugs to discontinue? Turkish J Nephrol. 2024;33:40-7.
- Rencuzogullari I, Çağdaş M, Karakoyun S, Karabağ Y, Yesin M, Gürsoy MO et al. Association of syntax score ii with contrast-induced nephropathy and hemodialysis requirement in patients with st segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Korean Circ J. 2018;48:59-70.
- Bağcı A, Aksoy F, Baş HA. Akut koroner sendromda kontrast nefropati gelişimi ile syntax skoru arasındaki ilişki. Cukurova Medical Journal. 2019;44:1181-8.
- 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;44:1393-9.
- Zhu J, Yu P, Zhang X, Li X, Huang J, Zhao S et al. Preoperative systemic immune-inflammation index as a predictor of contrast-induced acute kidney injury in coronary artery disease: A multicenter cohort study. Ren Fail. 2025;47:2474204.
- He T, Mohammadpour B, Willman M, Yaghoobpoor S, Willman J, Lucke-Wold B et al. Prognostic role of neutrophil to lymphocyte ratio in contrast-induced nephropathy: A systematic review and meta-analysis. Angiology. 2025;76:819-32.
- Yang M, Lin SQ, Liu XY, Tang M, Hu CL, Wang ZW et al. Association between c-reactive protein-albumin-lymphocyte (cally) index and overall survival in patients with colorectal cancer: From the investigation on nutrition status and clinical outcome of common cancers study. Front Immunol. 2023;14:1131496.
