High incidence and risk factors associated with contrast-induced nephropathy among adults undergoing coronary intervention in a tertiary hospital in Dodoma, Tanzania

Abstract

Abstract Introduction: Contrast-induced nephropathy (CIN) is the third most prevalent cause of hospital-acquired acute kidney injury. CIN may result in complications that might require renal replacement therapy thus early identification of patients at risk of CIN for better primary prevention is necessary. Methods: In this cross-sectional study, we included all patients in whom coronary intervention procedures were done from August 2021 to April 2022 at Benjamin Mkapa cardiac catheterization unit in Dodoma, Tanzania. Patients’ data were collected at baseline and patients were reviewed and laboratory investigations were done within 48 hours post-coronary interventions. Data analysis was done by the SPSS version 25 statistical program, descriptive statistics were used to summarize data; continuous data were reported as Mean (SD) or Median (IQR), and categorical data were summarized using proportions and frequencies. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with the development of contrast-induced nephropathy Results: A total of 187 patients were recruited for the study, the incidence of contrast-induced nephropathy was 100 (53.5%) patients. Among those with CIN, the median age was 61 years, 50.3% were female, 78.1% were married, 66.8% lived in urban, 84.5%were non-smokers, and 57.2% were not taking any alcohol. Patients with CIN had baseline median serum creatinine of 101.69 µmol/L, a hemoglobin level of 13.3 g/dl, random blood glucose of 5.55 mmol/l, systolic blood pressure of 145 mmHg and diastolic blood pressure of 86 mmHg. For patients with CIN the prevalence of hypertension was 97(97%) patients, CKD was found in 38 (38%) patients, heart failure was present in 39(39%) patients and diabetes mellitus was present in 29 (29%) patients. Variables with higher odds for CIN were; advanced age ≥ 70 years [OR 2.7 (95% CI: 1.12–6.52) P = 0.027], hypertension [OR 7.9(95% CI: 1.99–31.08) P = 0.003] and diabetes mellitus [ OR 3.3(95% CI: 1.39–7.84) P = 0.007]. Conclusion: The incidence of contrast-induced nephropathy after coronary interventions in our settings is high as compared to literature reports. Patients aged 70 years and above, those with hypertension and those with diabetes mellitus were at increased risk for CIN.