Association between creatinine and contrast-induced acute kidney injury in patients with type II diabetes mellitus post angiography

Abstract

The global population with type 2 diabetes mellitus (DM) is projected to increase from 460 to 700 million by 2045, significantly raising the risk of coronary artery disease (CAD). A coronary angiogram quantifies CAD severity, with contrast-induced acute kidney injury (CI-AKI) being a common adverse reaction and the third leading cause of hospital-acquired renal failure. Therefore, it is vital to assess the risk of post-angiography complications. A prospective cross-sectional cohort study was conducted by recruiting 95 patients receiving treatment for CAD at the National Hospital Sri Lanka. The study involved male and female patients aged 18 to 80 years, with data collected via an interviewer-administered questionnaire. The cohort comprised 66 men (69.47%) and 29 women (30.53%), with a mean age of 55.86 (+9.35). Among them, 51 had Type 2 DM, predominantly in the 41–60 age group. According to the Kidney Disease Improving Global Outcomes Guidelines, CI-AKI was observed in 7 out of 95 patients (7.4%) in the study. A strong correlation was found between CI-AKI and the pre-angiography serum creatinine levels (P=0.001, r= +0.441), White Blood Cell count (P=0.005, r=+0.286), duration of diabetes (P=0.001, r= +0.355) and type of diabetes treatment (P= 0.015, r= +0.297). The logistic regression model for predicting AKI based on pre-angiography serum creatinine levels has an AUC of 0.877, indicating high accuracy in distinguishing CI-AKI risk. The highest Youden's Index of the study was 0.705, indicating the optimal cutoff value of 1.085 for creatinine, which can be utilized as a biomarker to identify CI-AKI in clinical practice.