Harjai et al developed a grading system for contrast nephropathy. The authors are from Guthrie Clinic in Sayre, Pennsylvania.
Patient selection: exposure to contrast material
Time interval for creatinine measurements: 1.6 +/- 1.9 days (or 0-3.5 days after exposure)
Parameters:
(1) baseline serum creatinine in mg/dL
(2) serum creatinine in mg/dL after the contrast exposure
delta serum creatinine =
= (creatinine after) - (baseline creatinine)
increase as a percent =
= (delta creatinine) / (baseline creatinine)
delta serum creatinine
percent increase
Grade
<= 0.5 mg/dL
<= 25%
Grade 0
> 25%
Grade 1
> 0.5 mg/dL
NA
Grade 2
Severity
6-month MACE
no nephropathy
12.4%
mild nephropathy
19.4%
significant nephropathy
28.6%
where:
• MACE = major adverse cardiovascular events
All cause mortality at 3 years was 50% for patients in Grade 2 versus 10% for other grades.
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Specialty: Hematology Oncology, Nephrology