Angiotensin-converting enzyme inhibitors as a risk factor for contrast-induced nephropathy

Nephron Clin Pract. 2006;104(1):c20-7. doi: 10.1159/000093255. Epub 2006 May 9.

Abstract

Background/aims: The aim of the present study was to assess the influence of chronic angiotensin-converting enzyme (ACE) inhibitor administration on the development of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography.

Methods: A total of 230 patients with renal insufficiency and age > or =65 years were divided into two groups according to prior use of ACE inhibitors (ACE inhibitor group, n = 109; control group, n = 121). CIN was defined as an increase of > or =25% in creatinine over the baseline value within 48 h of angiography.

Results: CIN occurred in 17 patients (15.6%) in the ACE inhibitor group and 7 patients (5.8%) in the control group (p = 0.015). Serum creatinine level increased from 1.34 +/- 0.20 to 1.53 +/- 0.27 mg/dl in the ACE inhibitor group and from 1.33 +/- 0.18 to 1.45 +/- 0.19 mg/dl in the control group (p < 0.001). Chronic ACE inhibitor administration was a risk indicator of CIN [odds ratio 3.37; 95% confidence interval 1.14-9.94; p = 0.028]. Multi-vessel coronary involvement (p = 0.001), hypoalbuminemia (p = 0.005), diabetes mellitus (p = 0.006), GFR < or =40 ml/min (p = 0.010), and congestive heart failure (p = 0.024) were other risk indicators of CIN.

Conclusion: Chronic ACE inhibitor administration is a risk for developing CIN in elderly patients with renal insufficiency.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects*
  • Blood Urea Nitrogen
  • Case-Control Studies
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects*
  • Creatinine / blood*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney Diseases / chemically induced*
  • Male
  • Multivariate Analysis
  • Prospective Studies
  • ROC Curve
  • Renal Insufficiency / physiopathology
  • Risk Factors

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Contrast Media
  • Creatinine