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Clinical Trial
. 2017 Nov;39(1):555-560.
doi: 10.1080/0886022X.2017.1349673.

The predictive value of the product of contrast medium volume and urinary albumin/creatinine ratio in contrast-induced acute kidney injury

Chunrui Wang  1   2 , Shuai Ma  1 , Bo Deng  1 , Jianxin Lu  1 , Wei Shen  2 , Bo Jin  2 , Haiming Shi  2 , Feng Ding  1
Affiliations
Clinical Trial

The predictive value of the product of contrast medium volume and urinary albumin/creatinine ratio in contrast-induced acute kidney injury

Chunrui Wang et al. Ren Fail. 2017 Nov.

Abstract

Preexisting renal impairment and the amount of contrast media are the most important risk factors for contrast-induced acute kidney injury (CI-AKI). We aimed to investigate whether the product of contrast medium volume and urinary albumin/creatinine ratio (CMV × UACR) would be a better predictor of CI-AKI in patients undergoing nonemergency coronary interventions. This was a prospective single-center observational study, and 912 consecutive patients who were exposed to contrast media during coronary interventions were investigated prospectively. CI-AKI is defined as a 44.2 μmol/L rise in serum creatinine or a 25% increase, assessed within 48 h after administration of contrast media in the absence of other causes. Fifty patients (5.48%) developed CI-AKI. The urinary albumin/creatinine ratio (UACR) (OR = 1.002, 95% CI = 1.000-1.003, p = .012) and contrast medium volume (CMV) (OR = 1.008, 95% CI = 1.001-1.014, p = .017) were independent risk factors for the development of CI-AKI. The area under the ROC curve of CMV, UACR and CMV × UACR were 0.662 (95% CI = 0.584-0.741, p < .001), 0.761 (95% CI = 0.674-0.847, p < .001) and 0.808 (95% CI = 0.747-0.896, p < .001), respectively. The cutoff value of CMV × UACR to predict CI-AKI was 1186.2, with 80.0% sensitivity and 62.2% specificity. The product of CMV and UACR (CMV × UACR) might be a predictor of CI-AKI in patients undergoing nonemergency coronary interventions, which was superior to CMV or UACR alone.

Keywords: Contrast-induced acute kidney injury; contrast medium volume; coronary angiography; risk factors; urine albumin/creatinine ratio.

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Figures

Figure 1.
Figure 1.
The receiver operating characteristic curve of CMV, UACR and the product of CMV and UACR (CMV × UACR). The cutoff value (Youden index) of CMV × UACR to predict CI-AKI was 1186.2, with 80.0% sensitivity and 62.2% specificity. Abbreviations: CMV, volume of contrast media; UACR, urine albumin/creatinine ratio; CMV × UACR, the product of CMV and UACR.
Figure 2.
Figure 2.
The CI-AKI incidence and CMV × UACR. p < .001. Abbreviations: CMV, volume of contrast media; UACR, urine albumin/creatinine ratio; CMV × UACR, the product of CMV and UACR.
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