Abstract

Patient undergoing percutaneous coronary intervention (PCI) are at high risk of Contrast induced nephropathy (CIN). Calculated pre procedure serum osmolality has been demonstrated to be clinically useful for prediction of CIN after PCI. Objective: The aim of this study was to find the association of calculated pre-procedure serum osmolality with the development of CIN among patients undergoing PCI. Methods: This cross-sectional observational study was carriedout in the Department of Cardiology, National Heart Foundation Hospital and Research Institute, Mirpur, Dhaka. Total 280 consecutive patients with coronary artery disease undergone PCI within the study period were included in this study. Serum osmolality was calculated from laboratory results obtained before PCI using the following equation: [Osmolality=2Na+1.15(glucose in mg/18+urea/6]. Based on development of CIN, patients were divided into two groups. A Total of 36 Patient with CIN were included in group I and those 244 patients who did not develop CIN were included in group II. Results: In ourstudy over all Incidence of CIN was 12.9%. mean serum osmolality of the patient with CIN was 304.65±6.71 and 295.64±8.48 in a patient without CIN which is a statistically significant difference with a P-value <0.001. On multivariate logistic regression to clarify the independent association of CIN shows that after the effect of other variables serum osmolality is independently associated with CIN, OR 1.162 (95% CI; 1.087-1.243, P-value <0.001). ROC curve for calculated pre-procedure serum osmolality of the study population showed the area under the curve (AUC) is 0.794 (95% CI;0.710-0.879, P-value <0.001). The cutoff value of serum osmolarity for CIN prediction was >302.75 with a sensitivity of 72.2% and a specificity of 82.8%. Conclusion: High calculated pre procedure serum osmolality is significantly associated with development CIN after percutaneous coronary intervention.

Description

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