cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2016-31-3-61-67cardiotomsk-230Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУTIPS TO HELP A PRACTICAL DOCTORКОНТРАСТ-ИНДУЦИРОВАННАЯ НЕФРОПАТИЯ ПРИ ПЛАНОВЫХ ЭНДОВАСКУЛЯРНЫХ ВМЕШАТЕЛЬСТВАХ НА КОРОНАРНЫХ АРТЕРИЯХCONTRAST-INDUCED NEPHROPATHY AFTER ELECTIVE PERCUTANEOUS CORONARY INTERVENTIONSВершининаЕ. О.VershininaE. O.

канд. мед. наук, научный сотрудник отделения реабилитации больных сердечно-сосудистыми заболеваниями,

634012, г. Томск, ул. Киевская, 111а

oliver@cardio.tsu.ruРепинА. Н.RepinA. N.

докт. мед. наук, профессор, руководитель отделения реабилитации больных сердечно-сосудистыми заболеваниями,

634012, г. Томск, ул. Киевская, 111а

ran_12@mail.ruНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наукРоссияCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesRussian Federation2016061120163136167Copyright © Вершинина Е.О., Репин А.Н., 20162016Вершинина Е.О., Репин А.Н.Vershinina E.O., Repin A.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/230

Проведен ретроспективный анализ частоты контраст индуцированной нефропатии (КИН) и эффективности ее профилактики в условиях реальной клинической практики при плановых эндоваскулярных вмешательствах на коронарных артериях у пациентов со стабильной ишемической болезнью сердца (ИБС). В группе пациентов с преобладанием умеренного и высокого риска КИН (средний балл по шкале R. Mehran = 9), несмотря на проводимую профилактику, острое повреждение почек выявлено у 24 пациентов (16,8%). Увеличение сывороточного креатинина (сКр) в группе пациентов с КИН после эндоваскулярного вмешательства составило 42,5%, скорость клубочковой фильтрации (СКФ) снизилась на 31%, клиренс креатинина (КрКл) уменьшился на 29,05%. В целом КИН протекала доброкачественно, так как основные показатели функции почек в течение госпитального периода вернулись к исходным значениям, и потребности в заместительной почечной терапии не было ни у одного из пациентов с развившейся КИН.

The study consisted in a retrospective analysis of the frequency of contrast induced nephropathy (CIN) and the effectiveness of its prevention after elective endovascular interventions on the coronary arteries in patients with stable coronary artery disease (CAD). Despite ongoing prevention, acute kidney injury was found in 24 patients (16.8%) in the group of patients with a predominance of moderate and high risk CIN (average Mehran Risk Score = 9). The increase in serum creatinine in patients with CIN after endovascular intervention was 42.5%; glomerular filtration rate decreased by 31%; and creatinine clearance decreased by 29.05%. Overall CIN was benign as the main indicators of renal function returned to baseline levels during the hospital period and did not require renal replacement therapy in any of the patients who developed CIN.

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The authors declare that there are no conflicts of interest present.