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How can you estimate the risk of renal failure following contrast angioplasty

Source:

  1.  Mehran R, Aymong ED, Nikolsky E, et al. (2004). “A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation”. J. Am. Coll. Cardiol. 44 (7): 1393–9. doi:10.1016/j.jacc.2004.06.068PMID 15464318.

You can do that using a simplified scoring system as follows (tested mainly on coronary angioplasty though): [ excel file is provided also)

Risk Factors:
  • Systolic blood pressure <80 mm Hg – 5 points
  • Intraarterial balloon pump – 5 points
  • Congestive heart failure (Class III-IV or history of pulmonary edema) – 5 points
  • Age >75 y – 4 points
  • Hematocrit level <39% for men and <35% for women – 3 points
  • Diabetes – 3 points
  • Contrast media volume – 1 point for each 100 mL
  • Renal insufficiency:
    • Serum creatinine level >1.5 g/dL – 4 points
or
    • 2 for 40–60 mL/min/1.73 m2
    • 4 for 20–40 mL/min/1.73 m2
    • 6 for < 20 mL/min/1.73 m2
Scoring:
5 or less points
  • Risk of CIN – 7.5
  • Risk of Dialysis – 0.04%
6–10 points
  • Risk of CIN – 14.0
  • Risk of Dialysis – 0.12%
11–16 points
  • Risk of CIN – 26.1*
  • Risk of Dialysis – 1.09%
>16 points
  • Risk of CIN – 57.3
  • Risk of Dialysis – 12.8%