Predictive Value of Renal Artery Resistance Index Combined with Cys C,Scr,Ure and UA for Contrast Induced Nephropathy After PCI
Objective To investigate the predictive value of renal artery resistance index(RRI)combined with cys-tatin C(Cys C),serum creatinine(Scr),blood urea(Ure)and blood uric acid(UA)in the prediction of contrast induced nephropathy after percutaneous coronary intervention(PCI).Methods A total of 191 patients with coronary atheroscle-rotic heart disease underwent PCI in author's hospital from June 2021 to June 2022 were selected,and the levels RRI were detected at 24 h before angiography and 1 h,24 h after angiography,and the levels of Cys C,Scr,Ure and UA in periph-eral blood were also detected at 24 h before angiography and 12 h,24 h,48 h after angiography.The patients definitely di-agnosed as contrast nephropathy after operation were classified into contrast nephropathy group,and the rest were classi-fied into control group,and the levels of RRI,Cys C,Scr,Ure and UA of the two groups at each time point were com-pared;and the multivariate Logistic regression analysis method was used to analyze the risk factors of contrast induced ne-phropathy after PCI,then receiver operating characteristic(ROC)curve was used to evaluate the value of RRI combined with Cys C,Scr,Ure and UA at 24 h before an-giography in predicting contrast induced nephropathy.Results The incidence rate of contrast induced nephropa-thy after PCI was 10.99％(21/191).The results of single effect analysis showed that RRI levels in contrast nephropathy group were higher than those in control group at 24 h before,1 h and 24 h after angiography(all P＜0.05);the RRI at 1 h after angiography was higher than 24 h before angiography,and the RRI at 24 h after angiography was lower than 24 h before and 1 h after angiography of patients in contrast nephropathy group(all P＜0.05).The results of single effect a-nalysis showed that the levels of Cys C,Scr,Ure and UA in contrast nephropathy group were higher than those in control group at 24 h before,12 h,24 h and 48 h after angiography(all P＜0.05);in contrast nephropathy group the levels of Cys C,Scr,Ure and UA at 12 h,24 h and 48 h after angiography were higher than at 24 h before angiography(all P＜0.05),and higher at 24 h and 48 h after angiography than at 12 h after angiography(all P＜0.05),the levels of Cys C,Ure and UA at 48 h after angiography were lower than those at 24 h after angiography(all P＜0.05),and the level of Scr at 48 h after angiography was higher than that at 24 h after angiography(all P＜0.05).Multivariate Logistic regression analysis showed that age,history of hypertension,history of diabetes mellitus,dosage of contrast medium and level of RRI,Cys C,Scr,Ure and UA at 24 h before coronary angiography were risk factors for contrast induced nephropathy in patients with coronary heart disease after PCI(P＜0.05).According to the ROC curve,the sensitivity of single and combined detection of RRI,Cys C,Scr,Ure and UA at 24 h before coronary angiography in predicting the occurrence of contrast induced nephropathy after PCI were 76.19％,76.19％,71.43％,71.43％,71.43％and 90.48％respectively,and the specificity were 79.41％,80.00％,74.71％,77.65％,75.88％and 74.71％respectively,and the area under curve(AUC)were 0.759,0.765,0.737,0.747,0.746 and 0.890,respectively,and the sensitivity and AUC of joint prediction was higher than that of individual prediction.Conclusion The increase of RRI,Cys C,Scr,Ure and UA levels before coronary angiography are risk factors of contrast induced nephropathy after PCI of coronary artery disease,and the combined detection of them has a high predictive value for the occurrence of contrast induced nephropathy.
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