The Korean journal of internal medicine

  • 제29권2호
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  • Pages.203-209
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  • 2014
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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DOI QR코드

DOI QR Code

Effect of renin-angiotensin-system blockers on contrast-medium-induced acute kidney injury after coronary angiography

  • Goo, Ja-Jun (Department of Internal Medicine, Maryknoll Medical Center) ;
  • Kim, Jae-Joon (Department of Internal Medicine, Maryknoll Medical Center) ;
  • Kang, Ji-Hoon (Department of Internal Medicine, Maryknoll Medical Center) ;
  • Kim, Kyoung-Nyoun (Department of Internal Medicine, Maryknoll Medical Center) ;
  • Byun, Ki-Sup (Department of Internal Medicine, Maryknoll Medical Center) ;
  • Kim, Mi-Kyung (Department of Internal Medicine, Inje University College of Medicine) ;
  • Kim, Tae-Ik (Department of Internal Medicine, Maryknoll Medical Center)
  • 투고 : 2013.01.11
  • 심사 : 2013.09.11
  • 발행 : 2014.03.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: With the increasing incidence of cardiovascular disease, angiocardiography using contrast-enhancing media has become an essential diagnostic and therapeutic tool, despite the risk of contrast-medium-induced acute kidney injury (CIAKI). CIAKI may be exacerbated by renin-angiotensin-system (RAS) blockers, which are also used in a variety of cardiovascular disorders. This study evaluated the effects of RAS blockade on CIAKI after coronary angiography. Methods: Patients who underwent coronary angiography in our hospital between May 2009 and July 2011 were reviewed. Serum creatinine levels before and after coronary angiography were recorded. CIAKI was diagnosed according to an increase in serum creatinine > 0.5 mg/dL or 25% above baseline. Results: A total of 1,472 subjects were included in this study. Patients taking RAS blockers were older, had a higher baseline creatinine level, lower estimated glomerular filtration rate (eGFR), and had received a greater volume of contrast medium. After propensity score matching, no difference was observed between the RAS (+) and RAS (-) groups. Multiple logistic regression identified RAS blockade, age, severe heart failure, contrast volume used, hemoglobin level, and eGFR as predictors of CIAKI. Multiple logistic regression after propensity matching showed that RAS blockade was associated with CIAKI (odds ratio, 1.552; p = 0.026). Conclusions: This study showed that the incidence of CIAKI was increased in patients treated with RAS blockers.

키워드

참고문헌

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피인용 문헌

  1. Risk prediction models for contrast induced nephropathy: systematic review vol.351, pp.None, 2015, https://doi.org/10.1136/bmj.h4395
  2. Prevention Strategies of Contrast Medium Induced Nephropathy (CIN): A Review of the Current Literature vol.6, pp.3, 2014, https://doi.org/10.4236/ojneph.2016.63013
  3. Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: Results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) card vol.89, pp.3, 2014, https://doi.org/10.1002/ccd.26628
  4. Effectiveness of contrast-associated acute kidney injury prevention methods; a systematic review and network meta-analysis vol.19, pp.1, 2018, https://doi.org/10.1186/s12882-018-1113-0
  5. Renin-angiotensin-aldosterone system blockade is associated with higher risk of contrast-induced acute kidney injury in patients with diabetes vol.12, pp.7, 2020, https://doi.org/10.18632/aging.102982