What is the scoring system used to identify risk for contrast-induced nephropathy (CIN)?

Updated: Dec 18, 2018
  • Author: Anita Basu, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Risk stratification scoring systems have been devised to calculate an individual patient’s risk of developing CIN. This has mostly been done in patients undergoing percutaneous coronary intervention (PCI), especially those with preexisting risk factors. Mehran et al developed a scoring system based on points awarded to each of the following multivariate predictors [27] :

  • Hypotension = 5 points
  • Intra-aortic balloon pump (IABP) use = 5 points
  • CHF = 5 points
  • SCr >1.5 mg/dL = 4 points
  • Age >75 years = 4 points
  • Anemia = 3 points
  • Diabetes mellitus = 3 points
  • Contrast volume = 1 point for each 100 mL used

Risk categories by total calculated score, CIN rates, and requirements for dialysis were as follows:

  • Low risk (score of ≤5): CIN rate 7.5%, dialysis in 0.04%
  • Moderate risk (score of 6-10): CIN rate 14%, dialysis in 0.12%
  • High risk (score of 11-15): CIN rate 26.1%, dialysis in 1.09%,
  • Very high risk (score of ≥16): CIN rate 57.3%, dialysis in 12.6%

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