This is a multicenter prospective observational study, which consists of 860 patients who underwent cardiac catheterization. We measured SCr and eGFR before cardiac catheterization, on the following day, and 48–72 h post-procedure. Definition of CIN is changes in SCr ≥0.5 mg/dL or ≥25% from baseline 48–72 h after contrast exposure.
CIN occurred in 40 patients. SCr levels significantly increased from a baseline of 1.55 ± 1.08 mg/dL to 1.79 ± 1.26 mg/dL on the following day in patients with CIN (p < 0.0001), but significantly decreased from a baseline of 1.21 ± 0.65 mg/dL to 1.18 ± 0.61 mg/dL on the following day in those without CIN (p < 0.0001). eGFR significantly decreased from a baseline of 47.3 ± 28.3 mL/min/1.73 m2 to 40.6 ± 26.7 mL/min/1.73 m2 on the following day in patients with CIN (p < 0.0001), but significantly increased from a baseline of 53.1 ± 22.0 mg/dL to 53.6 ± 21.2 mg/dL on the following day in those without CIN (p = 0.0236). Receiver operating characteristic curve analysis indicated that SCr change ≥0.1 mg/dL [area under the curve (AUC) = 0.852, sensitivity 72.5%, specificity 86.1%] and eGFR change ≤−1.1 mL/min/1.73 m2 (AUC = 0.789, sensitivity 85.0%, specificity 64.9%) were the best cut-off values for predicting CIN. Multivariate logistic regression showed that a change in SCr ≥0.1 mg/dL [odds ratio (OR), 29.3; 95% confidence interval (CI), 10.8–96.2] and change in eGFR ≤−1.1 mL/min/1.73 m2 (OR, 69.7; 95% CI, 13.3–952) were powerful independent predictors of CIN.
Changes in SCr and eGFR on the day following cardiac catheterization predict the development of CIN.