Contrast-induced Nephropathy among Patients with Chronic Kidney Disease Undergoing Coronary Angiography and Percutaneous Coronary Intervention

Muhammad Shahid Iqbal, Arsalan Masoud; Aasif Hussain, Muhammed Muzaffar Mehmood; Namra Noukhaiz, Irfan Manzoor Bakhshi

doi:10.66838/

Authors

Muhammad Shahid Iqbal, Arsalan Masoud Author
Aasif Hussain, Muhammed Muzaffar Mehmood Author
Namra Noukhaiz, Irfan Manzoor Bakhshi Author

DOI:

https://doi.org/10.66838/

Keywords:

chronic kidney disease; coronary angiography; percutaneous coronary intervention; contrast-associated acute kidney injury; serum creatinine; contrast volume.

Abstract

Objective: To determine the frequency of contrast-induced nephropathy among patients with chronic kidney disease (CKD) undergoing coronary angiography or percutaneous coronary intervention (PCI).

Study Design, Place and Duration: Descriptive case series conducted in the cardiac catheterization service of Ittefaq Trust Hospital, Lahore, from 4 May 2026 to 3 August 2026.

Materials and Methods: Ninety adults aged 30–80 years with established CKD undergoing coronary angiography or PCI were included. Contrast-induced nephropathy was defined according to the study protocol as an increase in serum creatinine of at least 25% from baseline or an absolute increase of at least 0.5 mg/dL within 48–72 hours after contrast administration. Baseline estimated glomerular filtration rate (eGFR), comorbidities, procedure type, contrast volume and serial serum creatinine were assessed. Between-group comparisons were performed using distribution-appropriate tests. A two-variable logistic regression model examined baseline eGFR and contrast volume.

Results: Contrast-induced nephropathy occurred in 18 of 90 patients (20.0%; 95% CI 13.0%–29.4%). Its frequency was 5.1% in CKD stage 3a, 16.1% in stage 3b and 55.0% in stage 4 (p<0.001). Median baseline eGFR was lower in patients who developed nephropathy than in those who did not (27.85 vs 45.30 mL/min/1.73 m²; p<0.001). Contrast volume did not differ significantly between groups (p=0.848). In exploratory adjusted analysis, the odds ratio per 10 mL/min/1.73 m² higher eGFR was 0.37 (95% CI 0.21–0.65); the contrast-volume estimate was imprecise.

Conclusion: One in five patients met the study definition of contrast-induced nephropathy after coronary angiography or PCI. Events were more frequent with lower baseline kidney function, particularly in CKD stage 4. The findings support assessment of renal function before contrast exposure and careful interpretation of post-procedural creatinine changes