2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2006030301v1 17/10/2871    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weisbord, S. D. Articles by Palevsky, P. M. Search for Related Content PubMed PubMed Citation Articles by Weisbord, S. D. Articles by Palevsky, P. M. Related Collections Related Article

Associations of Increases in Serum Creatinine with Mortality and Length of Hospital Stay after Coronary Angiography

Steven D. Weisbord^*,, Huanyu Chen^,, Roslyn A. Stone^,, Kevin E. Kip, Michael J. Fine^,||, Melissa I. Saul^¶ and Paul M. Palevsky^*

^* Renal Section, VA Pittsburgh Healthcare System and the Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, ^|| Division of General Internal Medicine, Department of Medicine, and ^¶ Department of Medicine, Center for Biomedical Informatics, University of Pittsburgh School of Medicine, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, and Departments of Biostatistics and Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania

Address correspondence to: Dr. Steven D. Weisbord, VA Pittsburgh Healthcare System, Mailstop 111F-U, 7E Room 120, Pittsburgh, PA 15240, Phone: 412-688-6000 ext. 815911; Fax: 412-688-6908; E-mail: weisbordsd{at}upmc.edu

Received for publication March 31, 2006. Accepted for publication June 28, 2006.

The absence of a universally accepted definition of radiocontrast nephropathy (RCN) has hampered efforts to characterize effectively the incidence and the clinical significance of this condition. The objective of this study was to identify a clinically relevant definition of RCN by assessment of the relationships between increases in serum creatinine (Scr) of varying magnitude after coronary angiography and clinical outcomes. An electronic medical database was used to identify all patients who underwent coronary angiography at the University of Pittsburgh Medical Center during a 12-yr period and abstract Scr levels before and after angiography, as well as demographic characteristics and comorbid conditions. Changes in Scr after angiography were categorized into mutually exclusive categories on the basis of absolute and relative changes from baseline levels, with a separate category denoting "unknown" change. Discrete proportional odds models were used to examine the association between increases in Scr and 30-d in-hospital mortality and length of stay. A total of 27,608 patients who underwent coronary angiography were evaluated. Small absolute (0.25 to 0.5 mg/dl) and relative (25 to 50%) increases in Scr were associated with risk-adjusted odds ratios for in-hospital mortality of 1.83 and 1.39, respectively. Larger increases in Scr generally were associated with greater risks for these clinical outcomes. Small increases in Scr after the administration of intravascular radiocontrast are associated with adverse patient outcomes. This observation will help guide the postprocedure care of patients who undergo coronary angiography and has important implications for future studies that investigate RCN.

Related Article

This Month’s Highlights
J. Am. Soc. Nephrol. 2006 17: 2635-2636. [Full Text] [PDF]

This article has been cited by other articles:

				S. D. Weisbord, M. K. Mor, A. L. Resnick, K. C. Hartwig, P. M. Palevsky, and M. J. Fine Incidence and Outcomes of Contrast-Induced AKI Following Computed Tomography Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1274 - 1281. [Abstract] [Full Text] [PDF]

				S. D. Weisbord, M. K. Mor, A. L. Resnick, K. C. Hartwig, A. F. Sonel, M. J. Fine, and P. M. Palevsky Prevention, Incidence, and Outcomes of Contrast-Induced Acute Kidney Injury Arch Intern Med, June 23, 2008; 168(12): 1325 - 1332. [Abstract] [Full Text] [PDF]

				C. R. Parikh, S. G. Coca, Y. Wang, F. A. Masoudi, and H. M. Krumholz Long-term Prognosis of Acute Kidney Injury After Acute Myocardial Infarction Arch Intern Med, May 12, 2008; 168(9): 987 - 995. [Abstract] [Full Text] [PDF]

				M. Kimmel, M. Butscheid, S. Brenner, U. Kuhlmann, U. Klotz, and D. M. Alscher Improved estimation of glomerular filtration rate by serum cystatin C in preventing contrast induced nephropathy by N-acetylcysteine or zinc--preliminary results Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1241 - 1245. [Abstract] [Full Text] [PDF]

				B. B. Newsome, D. G. Warnock, W. M. McClellan, C. A. Herzog, C. I. Kiefe, P. W. Eggers, and J. J. Allison Long-term Risk of Mortality and End-Stage Renal Disease Among the Elderly After Small Increases in Serum Creatinine Level During Hospitalization for Acute Myocardial Infarction Arch Intern Med, March 24, 2008; 168(6): 609 - 616. [Abstract] [Full Text] [PDF]

				S. D. Weisbord and P. M. Palevsky Prevention of Contrast-Induced Nephropathy with Volume Expansion Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 273 - 280. [Abstract] [Full Text] [PDF]

				F. P. Hurst, E. M. Bohen, E. M. Osgard, D. K. Oliver, N. P. Das, S. W. Gao, and K. C. Abbott Association of Oral Sodium Phosphate Purgative Use with Acute Kidney Injury J. Am. Soc. Nephrol., December 1, 2007; 18(12): 3192 - 3198. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673