慢性肾病患者血液透析治疗后造影剂肾病的发生情况及其与UACR、CM/eGFR水平和MACE发生率的关系

Incidence of contrast induced nephropathy and its relationship with UACR,CM/eGFR and MACE in patients with chronic kidney disease after hemodialysis

目的分析慢性肾病患者血液透析治疗后造影剂肾病(CIN)的发生情况及其与尿白蛋白/肌酐比率(UACR)、造影剂用量与肾小球滤过率比值(CM/eGFR)水平和主要心血管不良事件(MACE)发生率的关系.方法将本院2018年12月至2021年1月期间收治的83例符合标准的行血液透析治疗的慢性肾病患者作为研究对象,根据是否出现CIN将患者分为CIN组(18例)和非CIN组(65例);检测两组患者血中的UACR、CM/eGFR水平和MACE发生率;采用logistics回归模型分析可能导致CIN发生的危险因素.结果CIN组患者的年龄及体重指数(BMI)均明显高于非CIN组,差异均有统计学意义(均P<0.01);CIN组患者的UACR、CM/eG-FR水平和MACE发生率均高于非CIN组,差异均有统计学意义(均P<0.01);UACR、CM/eGFR水平和MACE发生是影响CIN发生和发展的独立危险因素(均P<0.05).结论慢性肾病患者血液透析治疗后的CIN患者体内UACR、CM/eGFR水平和MACE发生率均升高,且UACR、CM/eGFR水平和MACE发生可能是导致患者出现CIN的独立危险因素.

Objective To analyze the incidence of contrast induced nephropathy and its relationship with urinary albumin/creatinine ratio(UACR),the ratio of contrast medium/estimated filtration rate(CM/eGFR)and the incidence of major adverse cardiovascular events(MACE)in patients with chronic kidney disease after hemodialysis.Methods A total of 83 patients with chronic kidney disease who were admitted to our hospital from December 2018 to January 2021 were enrolled as the study subjects.According to the occurrence of CIN,the patients were divided into CIN group(18 cases)and non-CIN group(65 cases).UACR,CM/eGFR and the incidence of MACE were detected.Risk factors that may lead to CIN were analyzed by logistics regression model.Results Age and body mass index(BMI)in CIN group were significantly higher than those in non-CIN group,with statistical significance(all P<0.01).The levels of UACR,CM/eGFR and the incidence of MACE in CIN group were significantly higher than those in non-CIN group,with statistical significance(all P<0.01).UACR,CM/eGFR level and MACE occurrence were independent factors affecting the occurrence and development of CIN(all P<0.05).Conclusions UACR and CM/eGFR levels and the incidence of MACE in CIN patients with chronic kidney disease after hemodialysis treatment were significantly increased,and ACR and CM/eGFR levels and the incidence of MACE may be independent risk factors leading to THE occurrence of CIN in patients.The levels of UACR,CM/eGFR and the incidence of MACE are significantly increased in patients with CIN after hemodialysis.UACR,CM/eGFR and the incidence of mace are independent risk factors for CIN.