JHSM

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Metabolic syndrome as a risk factor in contrast-induced acute kidney injury
Aims: The expanding use of contrast media has made contrast-induced acute kidney injury (CI-AKI) a cause of acute renal failure. This study investigated the relationship between metabolic syndrome (MS), insulin resistance, and contrast-induced acute kidney injury.
Methods: This study encompassed 94 hospitalized patients (73 male) with creatinine levels of 1.0 and above who underwent contrast-enhanced computed tomography for various reasons in the internal medicine clinics of Dicle University Faculty of Medicine. Patients whose creatinine levels were routinely measured before and 48 hours after tomography and whose anamnesis information was sufficient for the International Diabetes Federation metabolic syndrome criteria were retrospectively included in the study. HOMA-IR values were calculated.
Results: CI-AKI developed in 10 (10.6%) patients out of 94. MS was identified in 60% of the group that developed CI-AKI and 38.1% that did not. Insulin resistance was observed in 30% of the group that developed CI-AKI and 17.9% that did not. Despite the observed difference, it did not achieve statistical significance. Considerable differences were found between the two groups regarding albumin, urea, creatinine, uric acid, C-reactive protein, and hemoglobin levels. CI-AKI was significantly more common in individuals with low creatinine clearance and in those with creatinine ?1.3 mg/dl.
Conclusion: Our study showed that a higher rate of patients with MS was detected in the group with CI-AKI. MS has been accused of being a risk factor for CI-AKI. Therefore, caution should be exercised when administering contrast to patients with MS.


1. Detrenis S, Meschi M, Musini S, Savazzi G. Lights and shadows on the pathogenesis of contrast-induced nephropathy: state of the art. Nephrol Dial Transplant. 2005;20(8):1542-1550.
2. Davenport MS, Cohan RH, Khalatbari S, Ellis JH. The challenges in assessing contrast-induced nephropathy: where are we now? AJR Am J Roentgenol. 2014;202:784-789. doi:10.2214/AJR.13.11369
3. Davenport MS, Perazella MA, Yee J, et al. Use of intravenous iodinated contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology. 2020;294:660-668. doi: 10.1148/radiol.201919 2094
4. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-c184. doi:10.1159/000339789
5. van der Molen AJ, Reimer P, Dekkers IA, et al. Post-contrast acute kidney injury-part 1: Definition, clinical features, incidence, role of contrast medium and risk factors: recommendations for updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol. 2018;28(7):2845-2855. doi:10.1007/s00330-017-5246-5
6. Moos SI, van Vemde DN, Stoker J, Bipat S. Contrast induced nephropathy in patients undergoing intravenous (IV) contrast enhanced computed tomography (CECT) and the relationship with risk factors: a meta-analysis. Eur J Radiol. 2013;82(9):e387-e399. doi:10.1016/j.ejrad.2013.04. 029
7. Toprak O, Cirit M, Yesil M, et al. Metabolic syndrome as a risk factor for contrast-induced nephropathy in non-diabetic elderly patients with renal impairment. Kidney Blood Press Res. 2006;29(1):2-9. doi:10.1159/ 000092481
8. Lebovitz HE. Insulin resistance: definition and consequences. Exp Clin Endocrinol Diabetes. 2001;109(Suppl 2):S135-S148. doi:10.1055/ s-2001-18576
9. Lebovitz HE. Oral therapies for diabetic hyperglycemia. Endocrinol Metab Clin North Am. 2001;30(4):909-933. doi:10.1016/s0889-8529(05) 70221-8
10. Li Y, Wang J. Contrast-induced acute kidney injury: a review of definition, pathogenesis, risk factors, prevention and treatment. BMC Nephrol. 2024;25(1):140. doi:10.1186/s12882-024-03570-6
11. Gussenhoven MJ, Ravensbergen J, van Bockel JH, Feuth JD, Aarts JC. Renal dysfunction after angiography; a risk factor analysis in patients with peripheral vascular disease. J Cardiovasc Surg (Torino). 1991;32(1): 81-86.
12. Kidney Disease Outcome Quality Initiative. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:17-31.
13. Maddox TG. Adverse reactions to contrast material: recognition, prevention, and treatment. Am Fam Physician. 2002;66(7):1229-1234.
14. Scharnweber T, Alhilali L, Fakhran S. Contrast-induced acute kidney injury: pathophysiology, manifestations, prevention, and management. Magn Reson Imaging Clin N Am. 2017;25(4):743-753. doi:10.1016/j.mric. 2017.06.012
15. Kusirisin P, Chattipakorn SC, Chattipakorn N. Contrast-induced nephropathy and oxidative stress: mechanistic insights for better interventional approaches. J Transl Med. 2020;18(1):400. doi:10.1186/s12967-020-02574-8
16. Hansel B, Giral P, Nobecourt E, et al. Metabolic syndrome is associated with elevated oxidative stress and dysfunctional dense high-density lipoprotein particles displaying impaired antioxidative activity. J Clin Endocrinol Metab. 2004;89(10):4963-4971. doi:10.1210/jc.2004-0305
17. Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. AJR Am J Roentgenol. 2004;183(6):1673-1689. doi:10.2214/ajr.183.6.01831673
18. Itoh Y, Yano T, Sendo T, Oishi R. Clinical and experimental evidence for prevention of acute renal failure induced by radiographic contrast media. J Pharmacol Sci. 2005;97(4):473-488. doi:10.1254/jphs.crj05002x
19. Toprak O, Cirit M. Risk factors and therapy strategies for contrast-induced nephropathy. Ren Fail. 2006;28(5):365-381. doi:10.1080/0886022 0600683524
20. Davidson CJ, Laskey WK, Hermiller JB, et al. Randomized trial of contrast media utilization in high-risk PTCA: the COURT trial. Circulation. 2000;101(18):2172-2177. doi:10.1161/01.cir.101.18.2172
21. Gruberg L, Mintz GS, Mehran R, et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol. 2000;36(5):1542-1548. doi:10.1016/s0735-1097(00)00917-7
22. Taliercio CP, Vlietstra RE, Ilstrup DM, et al. A randomized comparison of the nephrotoxicity of iopamidol and diatrizoate in high risk patients undergoing cardiac angiography. J Am Coll Cardiol. 1991;17(2):384-390. doi:10.1016/s0735-1097(10)80103-2
23. Lautin EM, Freeman NJ, Schoenfeld AH, et al. Radiocontrast-associated renal dysfunction: incidence and risk factors. AJR Am J Roentgenol. 1991;157(1):49-58. doi:10.2214/ajr.157.1.2048539
24. McCullough PA, Soman SS. Contrast-induced nephropathy. Crit Care Clin. 2005;21(2):261-280. doi:10.1016/j.ccc.2004.12.003
25. Andrade L, Campos SB, Seguro AC. Hypercholesterolemia aggravates radiocontrast nephrotoxicity: protective role of L-arginine. Kidney Int. 1998;53(6):1736-1742. doi:10.1046/j.1523-1755.1998.00906.x
26. Yang DW, Jia RH, Yang DP, Ding GH, Huang CX. Dietary hypercholesterolemia aggravates contrast media-induced nephropathy. Chin Med J (Engl). 2004;117(4):542-546.
27. Manske CL, Sprafka JM, Strony JT, Wang Y. Contrast nephropathy in azotemic diabetic patients undergoing coronary angiography. Am J Med. 1990;89(5):615-620. doi:10.1016/0002-9343(90)90180-l
28. Schillinger M, Haumer M, Mlekusch W, Schlerka G, Ahmadi R, Minar E. Predicting renal failure after balloon angioplasty in high-risk patients. J Endovasc Ther. 2001;8(6):609-614. doi:10.1177/152660280100800614
29. Gruberg L, Mintz GS, Mehran R, et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol. 2000;36(5):1542-1548. doi:10.1016/s0735-1097(00)00917-7
30. Mudge GH. Uricosuric action of cholecystographic agents. A possible factor in nephrotoxicity. N Engl J Med. 1971;284(17):929-933. doi:10. 1056/NEJM197104292841701
31. Ishizaka N, Ishizaka Y, Toda E, Nagai R, Yamakado M. Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals. Arterioscler Thromb Vasc Biol. 2005;25(5):1038-1044. doi:10.1161/01.ATV.0000161274.87407.26
32. Perlstein TS, Gumieniak O, Hopkins PN, et al. Uric acid and the state of the intrarenal renin-angiotensin system in humans. Kidney Int. 2004; 66(4):1465-1470. doi:10.1111/j.1523-1755.2004.00909.x
33. Wu MJ, Tsai SF, Lee CT, Wu CY. The predictive value of hyperuricemia on renal outcome after contrast-enhanced computerized tomography. J Clin Med. 2019;8(7):1003. doi:10.3390/jcm8071003
34. Kodzwa R. ACR manual on contrast media: 2018 updates. Radiol Technol. 2019;91(1):97-100. </ol> </div> <p>
Volume 8, Issue 3, 2025
Page : 476-482
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