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The Efficacy of the Cystatin C Based Glomerular Filtration Rate in the Estimation of Safe Contrast Media Volume

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Author(s)
Hyuck-Jun YoonHyungseop KimJae-Pil LeeSang-Woong ChoiHyun-Ok ChoHong-Won ShinHyoung-Seob ParkYun-Kyeong ChoChang-Wook NamSeung-Ho HurYoon-Nyun KimKwon-Bae Kim
Keimyung Author(s)
Yoon, Hyuck JunKim, Hyung SeopPark, Hyoung SeobCho, Yun KyeongNam, Chang WookHur, Seung HoKim, Yoon NyunKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Circulation Journal
Issued Date
2013
Volume
43
Issue
9
Keyword
Contrast mediaCystatin CGlomerular filtration rateAcute kidney injury
Abstract
Background and Objectives: The risk of contrast-induced nephropathy (CIN) is significantly influenced by baseline renal function and the amount of contrast media (CM). We evaluated the usefulness of the cystatin C (CyC) based estimated glomerular filtration rate (eGFRCyC) in the prediction of CIN and to determine the safe CM dosage. Subjects and Methods: We prospectively enrolled a total of 723 patients who received percutaneous coronary intervention (PCI) and investigated the clinical factors associated with the development of CIN. Renal function was calculated as eGFRCyC and a modified diet in the renal disease (MDRD) equation, respectively. Systemic exposure of CM was calculated as CM volume to eGFR ratio. We conducted a regression analysis to evaluate the predictive role of CM volume to eGFRCyC for the risk of CIN.
Results: The incidence of CIN was 4.0% (29/723). The patients with CIN had a lower hemoglobin level, decreased renal function, and a higher CyC value, and had greater CM exposure. Through multivariate regression analyses, hemoglobin {odds ratio (OR) 0.743, p=0.032}, CM volume/eGFRCyC (OR 1.697, p=0.006) and CM volume/MDRD (OR 2.275, p<0.001) were found to be independent predictors for CIN. In the receiver operating characteristic curve analysis, fair discrimination for CIN was found at a CM volume/eGFRCyC level of 4.493 (C-statics=0.814), and at this value, the sensitivity and specificity were 79.3% and 80.0%, respectively. Conclusion: Both the CM volume/MDRD and CM volume/eGFRCyC method would be simple, useful indicators for determining the safe CM-dose based on eGFR value before PCI. However, there was no significantly different predictive value between creatinine and CyC based GFR estimations.
Keimyung Author(s)(Kor)
윤혁준
김형섭
박형섭
조윤경
남창욱
허승호
김윤년
김권배
Publisher
School of Medicine
Citation
Hyuck-Jun Yoon et al. (2013). The Efficacy of the Cystatin C Based Glomerular Filtration Rate in the Estimation of Safe Contrast Media Volume. Korean Circulation Journal, 43(9), 622–627. doi: 10.4070/kcj.2013.43.9.622
Type
Article
ISSN
1738-5520
DOI
10.4070/kcj.2013.43.9.622
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36063
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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