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Diabetes With Preserved Renal Function Is an Independent Risk Factor for Renal Function Deterioration After Coronary Computed Tomography Angiography

Isobe, Satoshi MD, PhD*†; Yamada, Takashi MD; Sato, Kimihide RT§; Katagiri, Toshio RT§; Ohyama, Hisato RN; Hayashi, Mutsuharu MD, PhD; Yoshikawa, Daiji MD, PhD; Ishii, Hideki MD, PhD; Murohara, Toyoaki MD, PhD

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e31829a49aa
Thoracic and Cardiovascular Imaging
Abstract

Objectives: Diabetes mellitus (DM) and high fasting glucose levels are reportedly risk factors for contrast-induced nephropathy after invasive coronary angiography in patients with renal dysfunction. Cystatin C (CyC) is a sensitive marker for detecting early impairment of renal function. Using CyC, we investigated whether DM would be a risk for worsening renal function after coronary computed tomography angiography (CCTA) in patients with preserved renal function.

Methods: Two hundred twenty-eight patients scheduled for CCTA were enrolled. The serum CyC at preprocedure and 1 day after procedure, urinary microalbumin at preprocedure, and oral fluid volume for 24 hours after procedure were measured. The percentage changes in CyC from preprocedure to 1 day after procedure (%CyC) were also calculated.

Results: Ninety-eight patients had DM. The %CyC and urinary microalbumin were significantly greater in DM patients than in non-DM patients. The percentage of patients showing a %CyC of 10% or greater was significantly greater in DM patients than in non-DM patients (27% vs 8%, P < 0.01). Using multivariate regression analysis, oral fluid volume and urinary microalbumin were independent predictors for a %CyC of 10% or greater in DM patients (β = − 0.428 [P < 0.0001] and β = 0.464 [P < 0.0001], respectively).

Conclusions: Diabetes mellitus is a risk factor for worsening changes in renal function after CCTA, even in patients with preserved renal function. In particular, elevated microalbuminuria and low oral fluid intake are high-risk factors for renal functional deterioration.

Author Information

From the *Department of Cardiology, Isobe Naika Clinic, †Department of Cardiology, Nagoya University Graduate School of Medicine; and ‡Department of Cardiology and Divisions of §Radiological Technology and ∥Nursing, Kami-iida Dai-ichi General Hospital, Nagoya, Japan.

Received for publication April 13, 2013; accepted May 3, 2013.

Reprints: Satoshi Isobe, MD, PhD, Department of Cardiology, Isobe Naika Clinic, 3F Nichimaru Nagoya Bldg, 1–3 Shinsakae-machi, Naka-ku, Nagoya 460-0004, Japan (e-mail: sisobe@med.nagoya-u.ac.jp).

The authors declare no conflict of interest.

© 2013 by Lippincott Williams & Wilkins