Derivation and validation of a risk score for contrast-induced nephropathy after cardiac catheterization in Chinese patients

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Abstract
To derive and validate a risk score for prediction of contrast-induced nephropathy (CIN) in the Chinese patients undergoing cardiac catheterization. The hospital medical records of 3945 patients undergoing coronary angiography or percutaneous coronary intervention were reviewed. Patients were randomly assigned into two cohorts: one was for derivation of risk score (n = 2764) and another for validation (n = 1181). The CIN was defined as an increase of serum creatinine level ≥44.2 μmol/L or ≥25 % and beyond its upper limit of normal value within 72 h following the procedure. On the basis of the odds ratio obtained from multivariate logistic regression, risk score of CIN was built up. The discrimination of the risk score was assessed using the area under the receiver operating characteristic curve and the calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test. The incidences of CIN in the derivation and validation cohorts were 4.6 and 4.2 %, respectively. Independent predictors included age >60 years, hypertension, acute myocardial infarction, heart failure, use of intra-aortic balloon pump, decreased glomerular filtration rate and contrast volume >100 mL. The incidence of CIN was increased with increment of risk score. Both the derivation and validation cohorts showed adequate discrimination (an area under the ROC curve, 0.76 and 0.71, respectively) and good calibration (Hosmer–Lemeshow statistic test, P = 0.50 and P = 0.54, respectively). A simple risk score for prediction of CIN development after cardiac catheterization in Chinese patients was built up by this study. Use of this risk score may help clinicians to perform early preventative strategies to minimize the risk of CIN.

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