Contrast-Induced Nephropathy Risk Factor Scoring

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Contrast-Induced Nephropathy Risk Factor Scoring

Age > 75 years

Hematocrit Hct (%) Male: < 39 ; Female: < 36

Contrast Agent Dosage

GFR (ml/min/1.73m2)

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GFR (ml/min/1.73m2)

GFR > 60

GFR = 40-60

GFR = 20-39

GFR < 20

SBP < 80 mmHg for more than 1 hour within 24 hours after intervention, requiring positive inotropic support

Use of intra-aortic balloon pumping

Heart Failure (NYHA Class III or IV, or pulmonary edema)

Diabetes

Score:

Result Interpretation

Score	Risk Level	Incidence of Contrast-Induced Nephropathy	Estimated Dialysis Risk
< 5 points	Low Risk	7.5%	0.04%
6-10 points	Medium Risk	14%	0.12%
11-16 points	High Risk	26.1%	1.09%
> 16 points	Very High Risk	57.3%	12.6%

Explanation

Contrast-Induced Nephropathy (CIN) is defined as a new increase in serum creatinine > 25% from baseline or an absolute increase > 0.5 mg/dL (44 μmol/L) after the application of contrast agent, with no other apparent cause.

It generally occurs 24-48 hours after the application of the contrast agent, peaks at 5-7 days, and may return to normal within 7-10 days.

References

1. Barrett BJ, Parfrey PS. Clinical practice. Preventing nephropathy induced by contrast medium. N Engl J Med. 2006;354(4):379-86.

2. Mehran R, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44(7):1393-9.

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