Функциональное состояния почек у больных СД и ИБС в процессе ЧКВ с высоким риском контраст индуцированным острым повреждением почек на фоне применения превентивных мероприятий

Аннотация

Purpose of the study. Analysis of the pathogenetic mechanisms of the development of contrast nephropathy in patients with coronary artery disease against the background of type 2 diabetes mellitus and the effectiveness of proposed preventive measures. Materials and methods. The study took place in two stages. The collection of research material was carried out on the basis of the Department of Interventional Cardiology of the State Institution RSNPCT and MRRUz. The first stage - retrospective - included a comparative analysis of two groups of patients with diabetes mellitus who underwent an endovascular radiocontrast procedure (ECRP): 29 patients who developed contrast-induced acute kidney injury (CI-AKI) (CI-AKI+ group), and 27 patients whose post-procedural period proceeded without complications. CI-AKI was defined as an increase in venous blood creatinine concentration of more than 25% at the end of 48 hours after EVRC. Results of the study: based on the analysis, we developed a risk scale for the development of CI-AKI in patients with diabetes. In the process of compiling the scale, the RR value for the development of CI-AKI in the presence of a corresponding factor, rounded to a whole number, was used as risk coefficients (Table 3.6). According to the developed scale, if a risk factor is present, the patient is assigned a certain score. The total score determines the risk of CI-AKI. Conclusions: Taking into account the RR for the development of CI-AKI in patients with diabetes in the presence of identified predictors, a risk scale was developed. A risk score of 28 points and above demonstrates a predictive sensitivity in terms of the development of CI-AKI of 96.55% (p<0.001).