The predictive value of the prognostic nutritional index for contrast-induced nephropathy

Murat Gucun 1, Serkan Senger 2, Muzaffer Kahyaoğlu 3 * , Okan Akyuz 1, Mehmet Celik 4, Ahmet Guner 5, Yusuf Yilmaz 6
More Detail
1 Department of Nephrology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
2 Department of General Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
3 Department of Cardiology, Beykoz State Hospital, Istanbul, Turkey
4 Department of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
5 Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul , Turkey
6 Department of Cardiology, Goztepe Training and Research Hospital, Istanbul, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 19, Issue 1, pp. 46-49. https://doi.org/10.23950/jcmk/11585
OPEN ACCESS 1184 Views 811 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: This study aims to evaluate the association between prognostic nutritional index (PNI) and contrast-induced nephropathy (CIN).
Material and methods: A total of 251 patients who were at high risk for contrast nephropathy were included in the study. The patients were grouped according to their PNI score (PNI score <45 or PNI score ≥45). CIN was defined as a 25% relative increase, or 0.5 mg/dL absolute increase in serum creatinine level above baseline within 72 hours of contrast exposure, in the absence of an alternative explanation.
Results: Two groups were assigned according to the PNI score. The first group consists of 111 patients (PNI<45) and the second group has 140 patients (PNI≥45). CIN developed in 162 (%64.8) patients. C-reactive protein was higher in the low-PNI group. Also, the patients with the low-PNI group had lower ejection fraction, lower serum albumin levels, and lower hemoglobin levels. CIN, postprocedure renal replacement therapy requirement and in-hospital mortality were higher in the low PNI group.  Multivariable logistic regression analysis revealed that advanced age (p=0.012, [OR] = 1.044 [1.009-1.079]), low baseline GFR (p=0.033, [OR]= 1.022 [1.002-1.043]), high amount of contrast media (p=0.022, [OR]= 1.017 [1.002-1.031]), and low PNI score (p=0.033 , [OR]= 2.069 [1.060-4.039]) were independent predictors of CIN.
Conclusion: Our study demonstrated that the PNI score was an independent risk factor for the development of CIN.
Keywords: prognostic nutritional index, contrast induced nephropathy, coronary angiography, percutaneous coronary intervention

CITATION

Gucun M, Senger S, Kahyaoğlu M, Akyuz O, Celik M, Guner A, et al. The predictive value of the prognostic nutritional index for contrast-induced nephropathy. J CLIN MED KAZ. 2022;19(1):46-9. https://doi.org/10.23950/jcmk/11585

REFERENCES

  • Akash Nair Sethi, Jatinder Kohli, Ami M, Patel and Michael R. Contrast induced nephropathy. In: Lerma EV, Sparks MA, Topf JM, editors. Nephrology Secrets. 4th ed. Philedelphia: Elsevier; 2019. p. 94-8. https://doi.org/10.1016/B978-0-323-47871-7.00022-8
  • McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997;103(5):368-375. https://doi.org/10.1016/s0002-9343(97)00150-2
  • Ali A, Bhan C, Malik MB, Ahmad MQ, Sami SA. The Prevention and Management of Contrast-induced Acute Kidney Injury: A Mini-review of the Literature. Cureus. 2018;10(9):e3284. https://doi.org/10.7759/cureus.3284
  • Jeon HG, Choi DK, Sung HH, Jeong BC, Seo SI, Jeon SS, Choi HY, Lee HM. Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival in Renal Cell Carcinoma Patients Undergoing Nephrectomy. Ann Surg Oncol. 2016;23(1):321-327. https://doi.org/10.1245/s10434-015-4614-0
  • Chan AW, Chan SL, Wong GL, Wong VW, Chong CC, Lai PB, Chan HL, To KF. Prognostic Nutritional Index (PNI) Predicts Tumor Recurrence of Very Early/Early Stage Hepatocellular Carcinoma After Surgical Resection. Ann Surg Oncol. 2015;22(13):4138-4148. https://doi.org/10.1245/s10434-015-4516-1
  • Chen QJ, Qu HJ, Li DZ, Li XM, Zhu JJ, Xiang Y, Li L, Ma YT, Yang YN. Prognostic nutritional index predicts clinical outcome in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Sci Rep. 2017;7(1):3285. https://doi.org/10.1038/s41598-017-03364-x
  • Cheng YL, Sung SH, Cheng HM, Hsu PF, Guo CY, Yu WC, Chen CH. Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure. J Am Heart Assoc. 2017;6(6):e004876. https://doi.org/10.1161/JAHA.116.004876
  • Mohri Y, Inoue Y, Tanaka K, Hiro J, Uchida K, Kusunoki M. Prognostic nutritional index predicts postoperative outcome in colorectal cancer. World J Surg. 2013;37(11):2688-2692. https://doi.org/10.1007/s00268-013-2156-9
  • Sun XP, Li J, Zhu WW, Li DB, Chen H, Li HW, Chen WM, Hua Q. Platelet to Lymphocyte Ratio Predicts Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Angiology. 2018;69(1):71-78. https://doi.org/10.1177/0003319717707410
  • Stevens LA, Claybon MA, Schmid CH, Chen J, Horio M, Imai E, Nelson RG, Van Deventer M, Wang HY, Zuo L, Zhang YL, Levey AS. Evaluation of the Chronic Kidney Disease Epidemiology Collaboration equation for estimating the glomerular filtration rate in multiple ethnicities. Kidney Int. 2011;79(5):555-562. https://doi.org/10.1038/ki.2010.462
  • Onodera T, Goseki N, Kosaki G. [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi. 1984;85(9):1001-1005. Japanese. PMID: 6438478.
  • Hassan, M., Abdel Rehim, A. E., Khalil, M., Mahmoud Osman, Y. Nutritional assessment of cirrhotic patients with variable severity. Journal of Current Medical Research and Practice, 2019;4(2):144-151. https://doi.org/10.4103/JCMRP.JCMRP_14_18
  • Toso A, Leoncini M, Maioli M, Tropeano F, Di Vincenzo E, Villani S, Bellandi F. Relationship between inflammation and benefits of early high-dose rosuvastatin on contrast-induced nephropathy in patients with acute coronary syndrome: the pathophysiological link in the PRATO-ACS study (Protective Effect of Rosuvastatin and Antiplatelet Therapy on Contrast-Induced Nephropathy and Myocardial Damage in Patients With Acute Coronary Syndrome Undergoing Coronary Intervention). JACC Cardiovasc Interv. 2014;7(12):1421-1429. https://doi.org/10.1016/j.jcin.2014.06.023
  • Yuan Y, Qiu H, Hu X, Luo T, Gao X, Zhao X, Zhang J, Wu Y, Qiao S, Yang Y, Gao R. Predictive value of inflammatory factors on contrast-induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention. Clin Cardiol. 2017;40(9):719-725. https://doi.org/10.1002/clc.22722
  • Kaya A, Kaya Y, Topçu S, Günaydin ZY, Kurt M, Tanboğa IH, Kalkan K, Aksakal E. Neutrophil-to-lymphocyte ratio predicts contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention. Angiology. 2014;65(1):51-56. https://doi.org/10.1177/0003319713484789
  • Han M, Lee HW, Lee HC, Kim HJ, Seong EY, Song SH. Impact of nutritional index on contrast-associated acute kidney injury and mortality after percutaneous coronary intervention. Sci Rep. 2021;11(1):7123. https://doi.org/10.1038/s41598-021-86680-7
  • Chen L, Huang Z, Li W, He Y, Liang J, Lu J, Yang Y, Huang H, Lin Y, Lin R, Lin M, Liang Y, Hu Y, Ye J, Hu Y, Liu J, Liu Y, Fang Y, Chen K, Chen S. Malnutrition and the risk for contrast-induced acute kidney injury in patients with coronary artery disease. Int Urol Nephrol. 2021 Jun 25. https://doi.org/10.1007/s11255-021-02915-6
  • Kang SH, Cho KH, Park JW, Yoon KW, Do JY. Onodera's prognostic nutritional index as a risk factor for mortality in peritoneal dialysis patients. J Korean Med Sci. 2012;27(11):1354-1358. https://doi.org/10.3346/jkms.2012.27.11.1354
  • Peng F, Chen W, Zhou W, Li P, Niu H, Chen Y, Zhu Y, Long H. Low prognostic nutritional index associated with cardiovascular disease mortality in incident peritoneal dialysis patients. Int Urol Nephrol. 2017;49(6):1095-1101. https://doi.org/10.1007/s11255-017-1531-0
  • Dolapoglu A, Avci E, Kiris T, Bugra O. The predictive value of the prognostic nutritional index for postoperative acute kidney injury in patients undergoing on-pump coronary bypass surgery. J Cardiothorac Surg. 2019;14(1):74. https://doi.org/10.1186/s13019-019-0898-7