Investigation of the complete blood count parameters as an early diagnostic tool in contrast-induced nephropathy after contrast-enhanced computed tomography
Investigation of the complete blood count parameters as an early diagnostic tool in contrast-induced nephropathy after contrast-enhanced computed tomography
Aim: We investigated complete blood count parameters as inflammatory biomarkers and compared these to serum creatinine valuesas early diagnostic criteria of ongoing contrast-induced nephropathy. Contrast-induced nephropathy is an important cause of acutekidney injury. Early diagnosis can reduce morbidity and mortality. There is no clear predictor parameter for the early diagnosis ofcontrast-induced nephropathy.Material and Methods: Patients who underwent contrast-enhanced computed tomography examination were included in thisretrospective study. Contrast-induced nephropathy was defined as 25%, a higher increment or a 0.5 mg/dL elevation above thebaseline serum creatinine levels within 72 hours. Patients were divided into contrast-induced nephropathy and non-contrastinduced nephropathy groups. The complete blood count parameters obtained before and within the first 24 hours after contrastenhanced computed tomography were compared between groups.Results: The post-contrast-enhanced computed tomography neutrophil-to-lymphocyte ratio values were significantly higher inthe contrast-induced nephropathy group compared to the non-contrast-induced nephropathy group (11.85±1.56 vs 7.29±0.49;p = 0.000). Comparison of the post-contrast-enhanced computed tomography values of the platelet-to-lymphocyte ratio, meanplatelet volume-to-platelet count ratio, and lymphocyte to monocyte ratio revealed no statistically significant differences betweenthe groups (p = 0.283, 0.128, and 0.792 respectively).Conclusions: An increased neutrophil-to-lymphocyte ratio level after a contrast-enhanced computed tomography procedure isassociated with the development of contrast-induced nephropathy. The use of the neutrophil-to-lymphocyte ratio in the emergencydepartment as a predictive parameter can significantly improve the diagnostic process, favorably acting on the prognosis of patientsdeveloping contrast-induced nephropathy.
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- 1. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930-6.
- 2. Chuang FR, Chen TC, Wang IK, et al. Comparison of iodixanol and iohexol in patients undergoing intravenous pyelography: a prospective controlled study. Ren Fail 2009;31:181-8.
- 3. Sadat U. Radiographic contrast-media-induced acute kidney injury: pathophysiology and prophylactic strategies. ISRN Radiol 2013;2013:496438.
- 4. Yin WJ, Yi YH, Guan XF, et al. Preprocedural prediction model for contrast-induced nephropathy patients. J Am Heart Assoc 2017;6:e004498.
- 5. McCullough PA. Contrast-induced acute kidney injury. J Am Coll Cardiol 2008;51:1419-28.
- 6. Mohammed NM, Mahfouz A, Achkar K, et al. Contrastinduced nephropathy. Heart Views 2013;14:106-16.
- 7. Rabb H, Griffin MD, McKay DB, et al. Inflammation in AKI: Current understanding, key questions, and knowledge gaps. J Am Soc Nephrol 2016;27:371-9.
- 8. Linfert D, Chowdhry T, Rabb H. Lymphocytes and ischemia-reperfusion injury. Transplant Rev (Orlando) 2009;23:1-10.
- 9. Liu X, Zhang Q, Wu H, et al. Blood neutrophil to lymphocyte ratio as a predictor of hypertension. Am J Hypertens 2015;28:1339-46.
- 10. Luo Y, She DL, Xiong H, et al. Pretreatment neutrophil to lymphocyte ratio as a prognostic predictor of urologic tumors: A systematic review and metaanalysis. Medicine (Baltimore) 2015;94:e1670.
- 11. Wagdy S, Sobhy M, Loutfi M. Neutrophil/lymphocyte ratio as a predictor of in-hospital major adverse cardiac events, new-onset atrial fibrillation, and noreflow phenomenon in patients with ST elevation myocardial infarction. Clin Med Insights Cardiol 2016;10:19-22.
- 12. Ganti L GR, Gilmore RM, Weaver AL, et al. Prognostic value of complete blood count and electrolyte panel during emergency department evaluation for acute ischemic. ISRN Stroke 2013;2013:974236.
- 13. Erdem E. Neutrophil lymphocyte ratio in acute renal failure. Indian J Nephrol 2015;25:126-7.
- 14. Weisbord SD, Palevsky PM. Strategies for the prevention of contrast-induced acute kidney injury. Curr Opin Nephrol Hypertens 2010;19:539-49.
- 15. Abu Alfeilat M, Slotki I, Shavit L. Single emergency room measurement of neutrophil/lymphocyte ratio for early detection of acute kidney injury (AKI). Intern Emerg Med 2018;13:717-25.
- 16. Kurtul A, Yarlioglues M, Duran M, et al. Association of neutrophil-to-lymphocyte ratio with contrast-induced nephropathy in patients with non-ST-elevation acute coronary syndrome treated with percutaneous coronary intervention. Heart Lung Circ 2016;25:683- 90.
- 17. Demircelik MB, Kurtul A, Ocek H, et al. Association between platelet-to-lymphocyte ratio and contrastinduced nephropathy in patients undergoing percutaneous coronary intervention for acute coronary syndrome. Cardiorenal Med 2015;5:96-104.
- 18. Gong S, Gao X, Xu F, et al. Association of lymphocyte to monocyte ratio with severity of coronary artery disease. Medicine (Baltimore) 2018;97:e12813.
- 19. Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J 2001;22:1561-71.