الفهرس 
Contrast Induced Acute Kidney InjuryOnly 14 pages are availabe for public view
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Abstract
Contrast-induced nephropathy (CIN) is defined as the development of acute kidney injury (AKI) following the administration of radiographic contrast media in the absence of other identifiable causes.
Contrast-induced nephropathy is a common and serious complication of contrast used in imaging studies, and is the third leading cause of acute kidney injury in hospitalized patients. Patients who develop contrast-induced nephropathy after percutaneous coronary intervention sustain an increase in both short and long-term mortality and an increase in length of stay.
The renal resistive index (RRI) is a simple noninvasive Doppler-measured parameter, and high renal resistive index is predictive of acute kidney injury.
In this prospective, observational study, we sought to assess the efficiency of the Doppler-based RI in predicting the development of contrast induced nephropathy following coronary angiography.
One hundred patients who underwent coronary catheterization were enrolled in our study, all have at least two known factors for AKI. Patients who suffer from any other disease that may affect kidney function, patients with renal artery stenosis were excluded. RI was measured before and immediately after the patients underwent coronary catheterization, and we compared the RI values between the group of patients who developed AKI and those who didn’t.
It was shown that age, diabetes, and heart failure were risk factors that were mostly associated with increased RI before angiography.
The results of the study showed that AKI was encountered in 19 patients after cardiac catheterization. By comparing values of RI in those patients and those who didn’t develop AKI, it was found that RI was significantly higher and statistically significant in the group of patients who developed AKI, in contrast to the other group. By performing the necessary statistical calculations, an RRI >0.744 was able to predict post- interventional AKI with a sensitivity of 94% and a specificity of 92%, and was superior to the prediction of CI-AKI by Mehran risk score. Also change in RRI (∆RRI) achieved high specificity and sensitivity values.
The study had some limitations such as the small size of the sample and the diversity of disease characteristics of the participants in the study.
Conclusion
Our study showed that in high risk patients for contrast induced acute kidney injury, the Doppler based renal resistive index that is measured early after cardiac catheterization is useful in predicting contrast induced acute kidney injury in contrast to serum creatinine related markers, whose increase were shown to be delayed. Assessing RRI might allow for optimizing periprocedural renal function preventive strategies. Further studies are warranted to investigate the value of RRI in guiding therapeutic management and impact of preventive strategies on acute kidney injury incidence and severity