Relationship between red cell distribution width and contrast-induced nephropathy in patients who underwent primary percutaneous coronary intervention

Turk Kardiyol Dern Ars. 2015 Oct;43(7):613-20. doi: 10.5543/tkda.2015.37941.

Abstract

Objective: This study evaluated the relationship between contrast-induced nephropathy (CIN) and red cell distribution width (RDW) in patients who underwent primary percutaneous coronary intervention (PCI).

Methods: A total of 359 patients with ST elevation myocardial infarction (STEMI) who had undergone primary PCI were included in the study. An increase of 25% in serum creatinine value after 48 h, or an increase of >0.5 mg/dL in the basal value was defined as CIN.

Results: Of the patients included in the study, 49 (13.8%) developed CIN. Compared to the CIN-negative group, CIN-positive patients had increased RDW values (16.9 ± 2.00 and 14.8 ± 2.14 respectively, p<0.001). The latter were also older patients, and had increased age rates of diabetes mellitus, baseline creatinine, ∆-creatinine and amount of contrast media were higher and left ventricular ejection fraction and baseline glomerular filtration rate (GFR) were lower in the CIN-positive group than in the CIN-negative group. A statistically weak correlation was found between RDW and change in creatinine levels (∆-creatinine) (r=0.250, p=0.002). Diabetes mellitus (odds ratio [OR]: 3.252, 95% CI=1.184-8.951, p=0.022), high RDW (OR: 1.716, 95% CI=1.363-2.157, p<0.001), baseline low GFR (OR: 0.941, 95% CI=0.925-0.971, p<0.001), ∆-creatinine (OR: 1.197, 95% CI=1.061-2.986, p=0.006) and increased amount of contrast media (OR: 1.187, 95% CI=1.048-3.02, p=0.001) used were observed as independent predictors of CIN.

Conclusion: The study found diabetes mellitus, high RDW, basal low GFR, ∆-creatinine and increased contrast amount used to be the independent predictors of CIN in STEMI patients who underwent PCI.

MeSH terms

  • Adult
  • Aged
  • Contrast Media / adverse effects*
  • Erythrocyte Indices
  • Female
  • Humans
  • Kidney Diseases / blood
  • Kidney Diseases / chemically induced
  • Kidney Diseases / etiology*
  • Male
  • Middle Aged
  • Myocardial Infarction / therapy*
  • Percutaneous Coronary Intervention / adverse effects
  • Postoperative Complications / blood
  • Postoperative Complications / etiology*
  • ROC Curve
  • Radiography, Interventional / adverse effects

Substances

  • Contrast Media