Study: Women Are At Higher Risk of RCIN
LAS VEGAS—Women with an estimated glomerular filtration rate (eGFR) of 60 mL/min/1.73 m2 or higher are at higher risk than men for experiencing radiocontrast-induced nephropathy (RCIN) following coronary angiography, data suggest.
Researchers at Henry Ford Hospital in Detroit led by Javier Neyra, MD, and James Novak, MD, PhD, studied 1,211 hospitalized patients who underwent coronary angiography. Of these, 481 (39.7%) had an eGFR of 15-59 and 730 (60.3%) had an eGFR of 60 or higher.
The study population included 530 women (43.8%): 242 with an eGFR of 15-59 and 288 with an eGFR of 60 or higher. RCIN developed in 105 women (19.8%) and 93 men (13.6%). After adjusting for potential confounders, female gender was independently associated with a 62% increased risk of RCIN, according to findings presented at the National Kidney Foundation's Spring Clinical Meetings. Subgroup analyses revealed that the risk of RCIN was significantly increased by nearly twofold among women with an eGFR of 60 or higher, but not significantly increased among those with an eGFR of 15-59.
The researchers identified other RCIN risk factors as well. Use of furosemide was associated with a significant 2.5 times increased risk and administration of contrast media volumes greater than 100 mL was associated with a significant 44% increased risk.
“The reason for the observed increased incidence of RCIN in women compared to men is unknown,” said Dr. Novak, Medical Director of Home Dialysis at Henry Ford Hospital and Assistant Professor of Medicine at Wayne State University in Detroit.
“Confounders such as age, hemoglobin, and blood pressure are often cited as engendering worse outcomes in women in some cardiovascular events studies. However, the increased risk of RCIN in women in our study persisted after multivariable adjustment for these factors, suggesting the presence of a gender-specific risk factor or factors. Our findings also suggest the need to carefully weigh the risks and benefits of coronary angiography in women.”