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Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri

Yıl 2021, Cilt: 11 Sayı: 2, 231 - 243, 01.08.2021

Öz

Amaç: Bu çalışmada akut miyokart enfarktüsü (AME) nedeniyle primerperkütan koroner girişim (pPKG) yapılan hastalarda kontrast-kaynaklı akut böbrek hasarı (KK-ABH) gelişiminde C-reaktif protein - albümin oranının (CAO) öngördürücü değerini belirlenmesi amaçlamaktadır.
Materyal ve Metot: Çalışmaya pPKG uygulanan ST-elevasyonsuz ve ST-elevasyonu 210 AME’li hasta dâhil edildi. Hastaların pPKG sonrası böbrek fonksiyon parametreleri ve en yüksek CAO değerleri hasta dosyalarından kaydedildi. Çalışma popülasyonunun CAO değerleri en küçükten en büyüğe doğru sıralandıktan sonra düşük-, orta- ve yüksek-CAO olmak üzere üç guruba ayrıldı (her n = 70).
Bulgular: Seksen dokuz hastada (% 42.38) KK-ABH gelişti. Serum kreatininindeki (sCr) mutlak artışı, yüksek-CAO gurubunda [.31, interquartilerange (IQR): 1.925-.555], düşük- (.2, IQR: .118 - .27) ve orta-CAO’dan önemli ölçüde daha yüksek bulundu (.2, IQR: .13 - .33; p < .001). Receiveroperatingcharacteristic analizde CAO’ya ait eğri altındaki alan 0.689 (95% CI: .614-.763; p < .001) bulundu. KK-ABH gelişimine neden olacak diğer risk faktörleri ayarlandıktan sonra yapılan çok değişkenli regresyon analizi, CAO’nun KK-ABH gelişimini öngördürecek olduğunu gösterdi (OR: 1.345,% 95 CI: 1.009-1.794, p = .043).
Sonuçlar: Yüksek CAO değerleri, pPCI uygulanan AME hastalarında KK-ABH gelişiminde bağımsız öngördürücüdür. Bu hasta grubunda, pPKG sonrası yüksek CAO değeri KK-ABH'nın gelişebileceği yönünde bizi uyarmalıdır.

Kaynakça

  • 1. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39(5):930-6.
  • 2. Gupta R, Birnbaum Y, Uretsky BF. The renal patient with coronary artery disease: current concepts and dilemmas. J Am Coll Cardiol 2004;44(7):1343-53.
  • 3. Rear R, Bell RM, Hausenloy DJ. Contrast-induced nephropathy following angiography and cardiac interventions. Heart 2016;102(8):638-48.
  • 4. Kwasa EA, Vinayak S, Armstrong R. The role of inflammation in contrast-induced nephropathy. The British journal of radiology 2014;87(1041):20130738-.
  • 5. Herrmann J, Lennon RJ, Barsness GW, Sandhu GS, Gulati R, Best PJ et al. High sensitivity C-reactive protein and outcomes following percutaneous coronary intervention in contemporary practice. Circ Cardiovasc Interv 2012;5(6):783-90.
  • 6. Ishida S, Hashimoto I, Seike T, Abe Y, Nakaya Y, Nakanishi H. Serum albumin levels correlate with inflammation rather than nutrition supply in burns patients: a retrospective study. J Med Invest 2014;61(3-4):361-8.
  • 7. Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. JPEN J Parenter Enteral Nutr 2019;43(2):181-93.
  • 8. Wu J, Tan W, Chen L, Huang Z, Mai S. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis. Oncotarget 2018;9(17):13934-47.
  • 9. Kim MH, Ahn JY, Song JE, Choi H, Ann HW, Kim JK et al. The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy. PLoS One 2015;10(7):e0132109.
  • 10. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39(2):119-77.
  • 11. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8(4):R204-12.
  • 12. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11(2):R31.
  • 13. Morcos SK, Thomsen HS, Webb JA. Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol 1999;9(8):1602-13.
  • 14. eGFR using CKD-EPI. Calculate by QxMD, https://qxmd.com/calculate/calculator_251/egfr-using-ckd-epi [accessed 30.06.19]
  • 15. Pannu N, Wiebe N, Tonelli M. Prophylaxis strategies for contrast-induced nephropathy. Jama 2006;295(23):2765-79.
  • 16. Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. Cmaj 2005;172(11):1461-71.
  • 17. McCullough PA. Acute kidney injury with iodinated contrast. Crit Care Med 2008;36(4 Suppl):S204-11.
  • 18. 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.
  • 19. Heyman SN, Clark BA, Kaiser N, Spokes K, Rosen S, Brezis M et al. Radiocontrast agents induce endothelin release in vivo and in vitro. J Am Soc Nephrol. 1992;3(1):58-65.
  • 20. Klause N, Arendt T, Lins M, Gronow G. Hypoxic renal tissue damage by endothelin-mediated arterial vasoconstriction during radioangiography in man. Adv Exp Med Biol 1998;454:225-34.
  • 21. Bakris GL, Burnett JC, Jr. A role for calcium in radiocontrast-induced reductions in renal hemodynamics. Kidney Int 1985;27(2):465-8.
  • 22. Liss P, Nygren A, Olsson U, Ulfendahl HR, Erikson U. Effects of contrast media and mannitol on renal medullary blood flow and red cell aggregation in the rat kidney. Kidney Int 1996;49(5):1268-75.
  • 23. Nygren A. Contrast media and regional renal blood flow. A study of the effects of ionic and non-ionic monomeric and dimeric contrast media in the rat. Acta Radiol Suppl. 1992;378 ( Pt 3):123-35.
  • 24. Schwartz D, Blum M, Peer G, Wollman Y, Maree A, Serban I et al. Role of nitric oxide (EDRF) in radiocontrast acute renal failure in rats. Am J Physiol 1994;267(3 Pt 2):F374-9.
  • 25. Heyman SN, Reichman J, Brezis M. Pathophysiology of radiocontrast nephropathy: a role for medullary hypoxia. Invest Radiol 1999;34(11):685-91.
  • 26. Hurlimann J, Thorbecke GJ, Hochwald GM. The liver as the site of C-reactive protein formation. J Exp Med 1966;123(2):365-78.
  • 27. Liu Y, Tan N, Zhou YL, Chen YY, Chen JY, Chen J et al. High-sensitivity C-reactive protein predicts contrast-induced nephropathy after primary percutaneous coronary intervention. J Nephrol 2012;25(3):332-40.
  • 28. Jian-Wei Z, Yu-Jie Z, Shu-Jun C, Qing Y, Shi-Wei Y, Bin N. Impact of preprocedural high-sensitivity C-reactive protein on contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention. Angiology 2014;65(5):402-7.
  • 29. Lazaros G, Zografos T, Oikonomou E, Siasos G, Georgiopoulos G, Vavuranakis M et al. Usefulness of C-Reactive Protein as a Predictor of Contrast-Induced Nephropathy After Percutaneous Coronary Interventions in Patients With Acute Myocardial Infarction and Presentation of a New Risk Score (Athens CIN Score). Am J Cardiol 2016;118(9):1329-33.
  • 30. Schalk BW, Visser M, Bremmer MA, Penninx BW, Bouter LM, Deeg DJ. Change of serum albumin and risk of cardiovascular disease and all-cause mortality: Longitudinal Aging Study Amsterdam. Am J Epidemiol 2006;164(10):969-77.
  • 31. Oduncu V, Erkol A, Karabay CY, Kurt M, Akgun T, Bulut M et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis 2013;24(2):88-94.
  • 32. Kurtul A, Ocek AH, Murat SN, Yarlioglues M, Demircelik MB, Duran M et al. Serum albumin levels on admission are associated with angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Angiology 2015;66(3):278-85.
  • 33. Murat SN, Kurtul A, Yarlioglues M. Impact of Serum Albumin Levels on Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention. Angiology 2015;66(8):732-7.
  • 34. Minamiyama Y, Takemura S, Inoue M. Albumin is an important vascular tonus regulator as a reservoir of nitric oxide. Biochem Biophys Res Commun 1996;225(1):112-5.
  • 35. Vuong TD, Braam B, Willekes-Koolschijn N, Boer P, Koomans HA, Joles JA. Hypoalbuminaemia enhances the renal vasoconstrictor effect of lysophosphatidylcholine. Nephrol Dial Transplant 2003;18(8):1485-92.
  • 36. Fleck A, Raines G, Hawker F, Trotter J, Wallace PI, Ledingham IM et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury. Lancet 1985;1(8432):781-4.
  • 37. Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial 2004;17(6):432-7.
  • 38. Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med (Lond) 2009;9(1):30-3.

The predictive value of C-reactive protein to albumin ratio to detect contrast-induced acute kidney injury in patients with acute myocardial infarction undergoing percutaneous coronary intervention

Yıl 2021, Cilt: 11 Sayı: 2, 231 - 243, 01.08.2021

Öz

Aim: The present study aims to investigate the predictive value of the peak C-reactive protein to reduced albumin ratio (CAR) in the development of contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (pPCI).
Material and Method: Two hundred and ten patients with non-ST and ST-elevation AMI undergoing pPCI were recorded. Renal function parameters and highest CAO values of the patients after pPCI were recorded from the patient files. The patient population was divided intothe low-, mid-, and high-CAR tertiles (all n = 70) after their CAR values were ranked from least to greatest.
Results: Eighty-nine (42.38%) patients developed CI-AKI. The absolute increase in serum creatinine (sCr) was significantly higher in patients in the high-CAR tertile (.31, interquartile range (IQR): 1.925-.555) than in the low-CAR (.2, IQR: .118-.27) and mid-CAR tertiles (.2, IQR: .13-.33; p <.001). The area under the curve of CAR was .689 (95% CI: .614-.763; p < .001) in the receiver operating characteristic analysis. After adjusting for other risk factors of CI-AKI, CAR remained predictors of the development of CI-AKI (OR: 1.345, 95% CI: 1.009-1.794, p = .043).
Conclusions: The elevated CAR value is independent predictors in the development of CI-AKI in patients with AMI undergoing pPCI.In this patient group, the elevated CAR value after pPKG may alert us to more improve CI-AKI.

Kaynakça

  • 1. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39(5):930-6.
  • 2. Gupta R, Birnbaum Y, Uretsky BF. The renal patient with coronary artery disease: current concepts and dilemmas. J Am Coll Cardiol 2004;44(7):1343-53.
  • 3. Rear R, Bell RM, Hausenloy DJ. Contrast-induced nephropathy following angiography and cardiac interventions. Heart 2016;102(8):638-48.
  • 4. Kwasa EA, Vinayak S, Armstrong R. The role of inflammation in contrast-induced nephropathy. The British journal of radiology 2014;87(1041):20130738-.
  • 5. Herrmann J, Lennon RJ, Barsness GW, Sandhu GS, Gulati R, Best PJ et al. High sensitivity C-reactive protein and outcomes following percutaneous coronary intervention in contemporary practice. Circ Cardiovasc Interv 2012;5(6):783-90.
  • 6. Ishida S, Hashimoto I, Seike T, Abe Y, Nakaya Y, Nakanishi H. Serum albumin levels correlate with inflammation rather than nutrition supply in burns patients: a retrospective study. J Med Invest 2014;61(3-4):361-8.
  • 7. Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. JPEN J Parenter Enteral Nutr 2019;43(2):181-93.
  • 8. Wu J, Tan W, Chen L, Huang Z, Mai S. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis. Oncotarget 2018;9(17):13934-47.
  • 9. Kim MH, Ahn JY, Song JE, Choi H, Ann HW, Kim JK et al. The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy. PLoS One 2015;10(7):e0132109.
  • 10. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39(2):119-77.
  • 11. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8(4):R204-12.
  • 12. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11(2):R31.
  • 13. Morcos SK, Thomsen HS, Webb JA. Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol 1999;9(8):1602-13.
  • 14. eGFR using CKD-EPI. Calculate by QxMD, https://qxmd.com/calculate/calculator_251/egfr-using-ckd-epi [accessed 30.06.19]
  • 15. Pannu N, Wiebe N, Tonelli M. Prophylaxis strategies for contrast-induced nephropathy. Jama 2006;295(23):2765-79.
  • 16. Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. Cmaj 2005;172(11):1461-71.
  • 17. McCullough PA. Acute kidney injury with iodinated contrast. Crit Care Med 2008;36(4 Suppl):S204-11.
  • 18. 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.
  • 19. Heyman SN, Clark BA, Kaiser N, Spokes K, Rosen S, Brezis M et al. Radiocontrast agents induce endothelin release in vivo and in vitro. J Am Soc Nephrol. 1992;3(1):58-65.
  • 20. Klause N, Arendt T, Lins M, Gronow G. Hypoxic renal tissue damage by endothelin-mediated arterial vasoconstriction during radioangiography in man. Adv Exp Med Biol 1998;454:225-34.
  • 21. Bakris GL, Burnett JC, Jr. A role for calcium in radiocontrast-induced reductions in renal hemodynamics. Kidney Int 1985;27(2):465-8.
  • 22. Liss P, Nygren A, Olsson U, Ulfendahl HR, Erikson U. Effects of contrast media and mannitol on renal medullary blood flow and red cell aggregation in the rat kidney. Kidney Int 1996;49(5):1268-75.
  • 23. Nygren A. Contrast media and regional renal blood flow. A study of the effects of ionic and non-ionic monomeric and dimeric contrast media in the rat. Acta Radiol Suppl. 1992;378 ( Pt 3):123-35.
  • 24. Schwartz D, Blum M, Peer G, Wollman Y, Maree A, Serban I et al. Role of nitric oxide (EDRF) in radiocontrast acute renal failure in rats. Am J Physiol 1994;267(3 Pt 2):F374-9.
  • 25. Heyman SN, Reichman J, Brezis M. Pathophysiology of radiocontrast nephropathy: a role for medullary hypoxia. Invest Radiol 1999;34(11):685-91.
  • 26. Hurlimann J, Thorbecke GJ, Hochwald GM. The liver as the site of C-reactive protein formation. J Exp Med 1966;123(2):365-78.
  • 27. Liu Y, Tan N, Zhou YL, Chen YY, Chen JY, Chen J et al. High-sensitivity C-reactive protein predicts contrast-induced nephropathy after primary percutaneous coronary intervention. J Nephrol 2012;25(3):332-40.
  • 28. Jian-Wei Z, Yu-Jie Z, Shu-Jun C, Qing Y, Shi-Wei Y, Bin N. Impact of preprocedural high-sensitivity C-reactive protein on contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention. Angiology 2014;65(5):402-7.
  • 29. Lazaros G, Zografos T, Oikonomou E, Siasos G, Georgiopoulos G, Vavuranakis M et al. Usefulness of C-Reactive Protein as a Predictor of Contrast-Induced Nephropathy After Percutaneous Coronary Interventions in Patients With Acute Myocardial Infarction and Presentation of a New Risk Score (Athens CIN Score). Am J Cardiol 2016;118(9):1329-33.
  • 30. Schalk BW, Visser M, Bremmer MA, Penninx BW, Bouter LM, Deeg DJ. Change of serum albumin and risk of cardiovascular disease and all-cause mortality: Longitudinal Aging Study Amsterdam. Am J Epidemiol 2006;164(10):969-77.
  • 31. Oduncu V, Erkol A, Karabay CY, Kurt M, Akgun T, Bulut M et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis 2013;24(2):88-94.
  • 32. Kurtul A, Ocek AH, Murat SN, Yarlioglues M, Demircelik MB, Duran M et al. Serum albumin levels on admission are associated with angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Angiology 2015;66(3):278-85.
  • 33. Murat SN, Kurtul A, Yarlioglues M. Impact of Serum Albumin Levels on Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention. Angiology 2015;66(8):732-7.
  • 34. Minamiyama Y, Takemura S, Inoue M. Albumin is an important vascular tonus regulator as a reservoir of nitric oxide. Biochem Biophys Res Commun 1996;225(1):112-5.
  • 35. Vuong TD, Braam B, Willekes-Koolschijn N, Boer P, Koomans HA, Joles JA. Hypoalbuminaemia enhances the renal vasoconstrictor effect of lysophosphatidylcholine. Nephrol Dial Transplant 2003;18(8):1485-92.
  • 36. Fleck A, Raines G, Hawker F, Trotter J, Wallace PI, Ledingham IM et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury. Lancet 1985;1(8432):781-4.
  • 37. Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial 2004;17(6):432-7.
  • 38. Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med (Lond) 2009;9(1):30-3.
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Ahmet Karakurt Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 11 Sayı: 2

Kaynak Göster

APA Karakurt, A. (2021). Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri. Kafkas Journal of Medical Sciences, 11(2), 231-243.
AMA Karakurt A. Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri. Kafkas Journal of Medical Sciences. Ağustos 2021;11(2):231-243.
Chicago Karakurt, Ahmet. “Akut Miyokart enfarktüsü Nedeniyle perkütan Koroner girişim Uygulanan Hastalarda Kontrast-Kaynaklı Akut böbrek Hasarı Tespitinde C-Reaktif Proteinin-albümin oranının öngördürücü değeri”. Kafkas Journal of Medical Sciences 11, sy. 2 (Ağustos 2021): 231-43.
EndNote Karakurt A (01 Ağustos 2021) Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri. Kafkas Journal of Medical Sciences 11 2 231–243.
IEEE A. Karakurt, “Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri”, Kafkas Journal of Medical Sciences, c. 11, sy. 2, ss. 231–243, 2021.
ISNAD Karakurt, Ahmet. “Akut Miyokart enfarktüsü Nedeniyle perkütan Koroner girişim Uygulanan Hastalarda Kontrast-Kaynaklı Akut böbrek Hasarı Tespitinde C-Reaktif Proteinin-albümin oranının öngördürücü değeri”. Kafkas Journal of Medical Sciences 11/2 (Ağustos 2021), 231-243.
JAMA Karakurt A. Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri. Kafkas Journal of Medical Sciences. 2021;11:231–243.
MLA Karakurt, Ahmet. “Akut Miyokart enfarktüsü Nedeniyle perkütan Koroner girişim Uygulanan Hastalarda Kontrast-Kaynaklı Akut böbrek Hasarı Tespitinde C-Reaktif Proteinin-albümin oranının öngördürücü değeri”. Kafkas Journal of Medical Sciences, c. 11, sy. 2, 2021, ss. 231-43.
Vancouver Karakurt A. Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri. Kafkas Journal of Medical Sciences. 2021;11(2):231-43.