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A NOVEL SCORING SYSTEM FOR PREDICTION OF CONTRAST INDUCED NEPHROPATHY IN CIRRHOSIS – THE ‘CINIC SCORE’ Cyriac A. Philips* 1, Amrish Sahney1, Awinash Kumar1, Lovkesh Anand1, Guresh Kumar2, Suman L. Nayak3, Rakhi Maiwall1 and Shiv K. Sarin1 1 Department of Hepatology and Transplant Medicine , 2 Department of Research, 3 Department of Nephrology, Institute of Liver and Biliary Sciences, New Delhi, India
BACKGROUND
RESULTS
Contrast induced nephropathy (CIN) is described in patients undergoing interventional cardiac procedures and a grading system for the same has been in use. (1)
SUMMARY In cirrhotics, independent risk factors of CIN include CTP>11,DM,HTN & baseline UA (>6.2mg/dL)
Earlier studies have shown that cirrhosis was not a risk factor for CIN and further, presence of ascites was the only factor that was associated with CIN in hospitalized cirrhotics. (2, 3)
The CINIC score ≥ 5 predicted CIN in 89% of cirrhotics, on validation yielded an AUROC 96.3% The presence of CTP>11 along with any other significant independent variable, or presence of all 3 independent variables apart from CTP predicted CIN
The predictors of development of CIN in cirrhotics has not been studied adequately. Area Under The Curve – Derivative Cohort, CINIC Score
OBJECTIVES 1. 2. 3. 4.
To study incidence of CIN in cirrhosis To determine predictors of CIN in cirrhosis To devise a scoring system that predict CIN To validate the scoring system in a similar cohort of patients
PATIENTS & METHODS Consecutive 350 patients of cirrhosis undergoing CECT of abdomen Contrast agent Omnipaque 300 (Iohexol, given at fixed dose of 1ml/kg; 300mg/ml Iodine)] Parameters assessed at baseline and 72 hours; Serum creatinine checked at 48 and 72 hours
Area
Std. Error .889
95% Confidence Interval
Lower Bound Upper Bound .023 .845 .933
Table 1 : Univariate Analysis Parameter Mean Albumin 1.7 INR 3.76 Serum Na 116.4 Uric Acid 6.65 CTP Score 13 MELD Score 27 Diabetes Hypertension -
