New approaches in education and health sciences management

New approaches in education and health sciences management

Risk Factors Associated with the Development of Contrast-Induced Nephropathy in Hospitalized Patients Undergoing Diagnostic Angiography

Document Type : Original Article

Author
Nader Ramazanzadeh Rohi
Department of Cardiology, Faculty of Medicine, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
10.22034/edus.2025.236077
Abstract
Introduction: Contrast-induced nephropathy (CIN) is one of the common and potentially serious complications following diagnostic imaging procedures using iodinated contrast media. It may lead to an increased incidence of acute kidney injury, prolonged hospitalization, and higher mortality rates. Identifying risk factors and effective preventive strategies plays a crucial role in reducing the occurrence of this complication. The aim of this study was to investigate factors associated with the development of contrast-induced nephropathy in hospitalized patients undergoing diagnostic angiography.
Methods: This prospective descriptive-analytical study was conducted on 95 hospitalized patients who underwent diagnostic angiography at Tehran Heart Center Hospital. Serum creatinine levels were measured before and 48–72 hours after contrast media administration. Data regarding age, sex, history of diabetes, hypertension, underlying chronic kidney disease, and the amount of fluid intake were collected. Contrast-induced nephropathy was defined as an increase of at least 0.5 mg/dL or a 25% rise in serum creatinine from baseline. Data were analyzed using descriptive statistics and analytical tests, including the chi-square test and independent t-test. Logistic regression analysis was performed to identify independent factors associated with the development of contrast-induced nephropathy.
Results: The findings showed that 18.9% of patients developed contrast-induced nephropathy. The occurrence of this complication was significantly associated with older age, the presence of diabetes, higher baseline serum creatinine levels, and inadequate fluid intake prior to angiography (p < 0.05). No significant association was observed between sex and the development of contrast-induced nephropathy (p > 0.05).
Conclusion: The results of this study indicate that contrast-induced nephropathy remains a significant complication among high-risk patients. Careful patient screening, optimization of hydration status, and close monitoring of renal function may play an important role in reducing the incidence of this complication and improving clinical outcomes.
Keywords
Contrast-Induced Nephropathy
Angiography
Serum Creatinine

Ethics Approval ID: IR.TUMS.REC.1393.214

1.             Chen J, Liu Q, He J, Li Y. Immune responses in diabetic nephropathy: Pathogenic mechanisms and therapeutic target. Front Immunol. 2022;13:958790. doi: 10.3389/fimmu.2022.958790
2.             Mahdirejei HA, Peeri M, Azarbayjani MA, Fattahi Masrour F. Fluoxetine combined with swimming exercise synergistically reduces lipopolysaccharide-induced depressive-like behavior by normalizing the HPA axis and brain inflammation in mice. Pharmacol Biochem Behav. 2023;232:173640. doi: 10.1016/j.pbb.2023.173640
3.             Correa-Rotter R, García-Trabanino R. Mesoamerican Nephropathy. Semin Nephrol. 2019;39(3):263-271. doi: 10.1016/j.semnephrol.2019.02.004
4. Wang Y, Li Y, Chen Z, Yuan Y, Su Q, Ye K, et al. GSDMD-dependent neutrophil extracellular traps promote macrophage-to-myofibroblast transition and renal fibrosis in obstructive nephropathy. Cell Death Dis. 2022;13(8):693. doi: 10.1038/s41419-022-05138-4
5. Kellner RL, Harris A, Ciulla L, Guidoboni G, Verticchio Vercellin A, et al. The Eye as the Window to the Heart: Optical Coherence Tomography Angiography Biomarkers as Indicators of Cardiovascular Disease. J Clin Med. 2024;13(3):829. doi: 10.3390/jcm13030829
6.             Nordjoe YE, Aubin Igombe SR, Chat L. Non-cardiovascular findings on chest CT angiography in children with congenital heart disease: How important are they? BMC Med Imaging. 2022;22(1):13. doi: 10.1186/s12880-022-00739-z
7.             Mortensen KH, Tann O. Computed tomography in paediatric heart disease. Br J Radiol. 2018;91(1092):20180201. doi: 10.1259/bjr.20180201
8.             Cornelia K, Krautwald-Junghanns ME. Heart Disease in Pet Birds - Diagnostic Options. Vet Clin North Am Exot Anim Pract. 2022;25(2):409-433. doi: 10.1016/j.cvex.2022.01.004
9. Zucker EJ, Koning JL, Lee EY. Cyanotic Congenital Heart Disease: Essential Primer for the Practicing Radiologist. Radiol Clin North Am. 2017;55(4):693-716. doi: 10.1016/j.rcl.2017.02.009
10. Amouzad Mahdirejei H, Peeri M, Azarbayjani MA, Masrour FF. Diazepam and exercise training combination synergistically reduces lipopolysaccharide-induced anxiety-like behavior and oxidative stress in the prefrontal cortex of mice. Neurotoxicology. 2023;97:101-108. doi: 10.1016/j.neuro.2023.06.004
11. Qi C, Mao X, Zhang Z, Wu H. Classification and Differential Diagnosis of Diabetic Nephropathy. J Diabetes Res. 2017;2017:8637138. doi: 10.1155/2017/8637138
12. Nishimura RA, O'Gara PT, Bavaria JE, Brindis RG, Carroll JD, Kavinsky CJ, et al. 2019 AATS/ACC/ASE/SCAI/STS Expert Consensus Systems of Care Document: A Proposal to Optimize Care for Patients With Valvular Heart Disease: A Joint Report of the American Association for Thoracic Surgery, American College of Cardiology, American Society of Echocardiography, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Soc Echocardiogr. 2019;32(6):683-707. doi: 10.1016/j.echo.2019.02.016
13. Nishimura RA, O'Gara PT, Bavaria JE, Brindis RG, Carroll JD, Kavinsky CJ,et al. 2019 AATS/ACC/ASE/SCAI/STS expert consensus systems of care document: A proposal to optimize care for patients with valvular heart disease: A Joint Report of the American Association for Thoracic Surgery, American College of Cardiology, American Society of Echocardiography, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Catheter Cardiovasc Interv. 2019;94(1):3-26. doi: 10.1002/ccd.28196
14. Sagoo MK, Gnudi L. Diabetic Nephropathy: An Overview. Methods Mol Biol. 2020;2067:3-7. doi: 10.1007/978-1-4939-9841-8_1
15. Zhang F, Lu Z, Wang F. Advances in the pathogenesis and prevention of contrast-induced nephropathy. Life Sci. 2020;259:118379. doi: 10.1016/j.lfs.2020.118379
16.          Friedman DJ, Pollak MR. APOL1 Nephropathy: From Genetics to Clinical Applications. Clin J Am Soc Nephrol. 2021;16(2):294-303. doi: 10.2215/CJN.15161219  
New approaches in education and health sciences management
Volume 3, Issue 2
July 2026
Summer 2026
Pages 1-10

  • Receive Date 11 March 2026
  • Revise Date 14 April 2026
  • Accept Date 10 May 2026