Predictors of Contrast-induced Acute Renal Injury in Patients With Acute Coronary Syndrome

Karaganda Medical University88 enrolled

Overview

This observational study aims to identify predictors of contrast-induced acute kidney injury (CI-AKI) in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Clinical, laboratory, and procedural factors will be analyzed to determine their association with the development of CI-AKI. The findings may help improve risk stratification and preventive strategies in this high-risk population.

This prospective observational study investigates predictors of contrast-induced acute kidney injury (CI-AKI) among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The study was conducted from November 2024 to June 2025 at a tertiary cardiac center. Patients with ACS who underwent coronary angiography or PCI were enrolled consecutively. Clinical characteristics, laboratory parameters, hydration status, use of nephrotoxic drugs, and type and volume of contrast media were recorded. Serum creatinine levels were measured before and 48-72 hours after contrast exposure, and CI-AKI was defined according to KDIGO criteria. The primary objective is to identify independent predictors of CI-AKI using multivariate analysis. Secondary objectives include evaluation of short-term outcomes, such as in-hospital complications and renal function recovery at 90 days. The results are expected to improve understanding of CI-AKI risk in real-world ACS patients and to support preventive strategies in interventional cardiology.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Acute Coronary Syndrome Contrast-Induced Acute Kidney Injury

Interventions

Observational data collectionOTHER

Data collected from routine clinical care to evaluate predictors of contrast-induced acute kidney injury after PCI. No intervention applied.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Age ≥ 18 years Diagnosis of acute coronary syndrome (STEMI or NSTEMI) confirmed by clinical, ECG, and laboratory findings Undergoing coronary angiography or percutaneous coronary intervention with intravascular contrast administration Provided informed consent to participate in the study Availability of baseline and follow-up serum creatinine values Exclusion Criteria: Known chronic kidney disease stage 4 or 5 (eGFR \< 30 mL/min/1.73 m²) or on dialysis Hemodynamic instability not related to acute coronary syndrome (e.g., septic shock) Exposure to intravenous contrast within the previous 7 days Use of nephrotoxic drugs (e.g., aminoglycosides, amphotericin B) within 72 hours prior to contrast exposure Active infection or inflammatory disease affecting renal function Pregnancy or breastfeeding Refusal or inability to provide informed consent

Locations (1)

Karaganda Medical University

Karaganda, Qaraghandy Oblysy, Kazakhstan

Outcomes

Primary Outcomes

Change in serum creatinine at 90 days

Change in serum creatinine level compared to baseline at 90-day follow-up after contrast exposure, to evaluate renal function recovery or persistent impairment.

Time frame: 90 days after contrast exposure

Incidence of Contrast-Induced Acute Kidney Injury (CI-AKI)

Occurrence of contrast-induced acute kidney injury (CI-AKI) defined as an increase in serum creatinine of ≥0.3 mg/dL (≥26.5 µmol/L) or ≥50% from baseline within 48-72 hours after exposure to iodinated contrast media, according to KDIGO criteria.

Time frame: Within 72 hours after contrast exposure

Secondary Outcomes

Changes in plasma TIMP-2 concentration

Assessment of urinary TIMP-2 levels 2 hours after contrast exposure to detect early markers of renal tubular injury

Time frame: 2 hours after contrast exposure

Data from ClinicalTrials.gov

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