Nephrology Book

Radiology

  • Contrast-Induced Nephropathy Risk Score

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Contrast-Induced Nephropathy Risk Score

Aka: Contrast-Induced Nephropathy Risk Score, Risk Score for Prediction of Contrast-Induced Nephropathy After Percutaneous Coronary Intervention
  1. Background
    1. Risk calculation is based on outcomes from contrast exposure with Percutaneous Coronary Intervention (PCI)
  2. Criteria: Risk Factors
    1. Points 5: Congestive Heart Failure
      1. NYHA Class III or IV or
      2. Pulmonary edema history
    2. Points 5: Hypotension
      1. Systolic Blood Pressure <80 mmHg for greater than one hour and
      2. Required inotropic medication support or intra-aortic balloon pump
    3. Points 5: Intra-Aortic Balloon Pump
    4. Points 4: Age over 75 years old
    5. Points 3: Anemia
      1. Men: Baseline Hematocrit <39%
      2. Women: Baseline Hematocrit <36%
    6. Points 3: Diabetes Mellitus
    7. Points ?: Contrast Media Volume
      1. Assign 1 point for every 100 ml of Contrast Media administered
    8. Points ?: Decreased GFR <60 ml/min/1.73m2
      1. Assign 2 points for eGFR 40-60 ml/min/1.73m2
      2. Assign 4 points for eGFR 20-40 ml/min/1.73m2 (or Creatinine Clearance >1.5 mg/dl)
      3. Assign 6 points for eGFR 20-40 ml/min/1.73m2
  3. Interpretation
    1. Total risk score 5 or less
      1. Contrast-Induced Nephropathy risk: 7.5%
      2. Dialysis risk: 0.04%
      3. Mortality risk (one year): 1.9%
    2. Total risk score 6 to 10
      1. Contrast-Induced Nephropathy risk: 14.0%
      2. Dialysis risk: 0.12%
      3. Mortality risk (one year): 5.5%
    3. Total risk score 11 to 15
      1. Contrast-Induced Nephropathy risk: 26.1%
      2. Dialysis risk: 1.09%
      3. Mortality risk (one year): 15.5%
    4. Total risk score 16 or more
      1. Contrast-Induced Nephropathy risk: 57.3%
      2. Dialysis risk: 12.6%
      3. Mortality risk (one year): 31.2%
  4. References
    1. Mehran (2004) J Am Coll Cardiol 44(7):1393-9 [PubMed]

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