Elektif koroner anjiyografi yapılan hastalarda hipomagnezemi ve kontrast ilişkili nefropati riski ilişkisi

Year 2023, , 18 - 22, 23.03.2023

Nail Burak Özbeyaz , Gökhan Gökalp , Engin Algul , Faruk Aydınyılmaz , Haluk Furkan Şahan , Mehmet Ali Felekoğlu , İlkin Gulıyev , Sinan İşçen

https://doi.org/10.18663/tjcl.1183898

Cited By: 1

Abstract

Amaç: Bu çalışma, hipomagnezeminin (hipoMg) elektif koroner anjiyografi sonrası kontrast kaynaklı nefropati (KKN) geliştirme riski üzerindeki etkisini değerlendirmeyi amaçlamaktadır.
Yöntem: Bu çalışma, üçüncü basamak bir eğitim ve araştırma hastanesinde yürütülen tek merkezli ileriye dönük, gözlemsel bir çalışmadır. 31 Aralık 2018 ve 28 Şubat 2022 tarihleri arasında koroner anjiyografi işlemi geçirmiş ve işlem öncesi başlangıç Mg seviyeleri olan 223 tane hasta bu çalışmaya dahil edilmiştir. CIN, uygulamadan sonra 48-72 saat içinde başlangıca göre serum kreatinin konsantrasyonunda >0.5 mg/dl veya > %25 artış olarak tanımlanmıştır. HipoMg, Mg< 1.60 mg/dL olarak tanımlanmıştır.
Bulgular: Kaydedilen 223 hastanın 28'inde (%12.6) KKN meydana geldi. KKN, hipoMg'si olan hastaların %36.4'ünde ve hipoMg'si olmayanların %11,3'ünde meydana gelmiştir. (P=0,02). Çok değişkenli lojistik regresyon analizi, başlangıç Mg düzeylerinin KKN' nin bağımsız öngörücüleri olduğunu bulunmuştur.
Sonuç: HipoMg, artan KKN riski ile ilişkilendirilmiştir. Bu sonuçlar, hipoMG’de magnezyum replasmanı yapılmasının, kontrast madde kullanılan tanısal/girişimsel işlemlerden önce fayda sağlayabileceğini düşündürmektedir.

Keywords

Hipomagnezemi, Koroner Anjiyografi, Kontrast Kaynaklı Nefropati

Hypomagnesemia and the risk of contrast-induced nephropathy in patients undergoing elective coronary angiography

Abstract

Objective: The present study aimed to assess the influence of hypomagnesemia (hypoMg) on the risk of developing contrast-induced nephropathy (CIN) after coronary angiography.
Methods: This is a single-center prospective, observational study conducted at a tertiary referral hospital. Between December 31, 2016, and February 28, 2021, 223 patients who had undergone coronary angiography procedures and had preprocedural baseline Mg levels were enrolled in this study. CIN was defined as an increase of >0.5 mg/dl or >25 % in serum creatinine concentration over baseline within 48-72 h after administration. HypoMg was defined as Mg< 1.60 mg/dL.
Results: Of 223 patients enrolled, CIN occurred in 28 patients (12.6%). CIN occurred in 36.4 % of the patients with hypoMg and 11.3 % of those with non-hypoMg (P=0.02). Multivariate logistic regression analysis found that baseline Mg levels were independent predictors of CIN.
Conclusion: HypoMg was associated with an increased risk for CIN. These results suggest magnesium replacement in hypomagnesemia may be beneficially indicated before diagnostic/interventional studies using contrast media.

Keywords

Hypomagnesemia, Coronary Angiography, Contrast-Induced Nephropathy

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