by Vincent M. Brandenburg, MD and Jürgen Floege, MD Department of Nephrology, University Hospital Aachen, Germany
Corresponding author: Vincent M. Brandenburg, MD Department of Nephrology & Clinical Immunology University Hospital Aachen Pauwelsstraße 30 D-52057 Aachen Germany Phone: 0049 - 241 - 8089532 FAX: 0049 - 241 - 8082446 Email: Vincent.Brandenburg@post.rwth-aachen.de
Case Vignette: A 79-year old woman was referred from a primary care hospital to the cardiology department of our university hospital with the diagnosis of a non-ST segment elevation myocardial infarction (N-STEMI) five days before. She felt well and was hemodynamically stable upon arrival. The maximum creatinine kinase level was 256 U/l (normal range < 174U/L) on the day of admission in the primary care hospital. Since then she was treated with metoprolol 47.5 mg, aspirin 100 mg, clopidogrel 75 mg, ramipril 2.5 mg, and atorvastatin 40 mg each one tablet per day as well as subcutaneous enoxaparin 7000 IU bid. Blood pressure was 138/81 mmHg and body weight was 68 kg (171 cm) upon arrival. An echocardiography examination revealed a normal systolic left ventricular function with hypokinesia at the apex of the left ventricle. Serum creatinine levels were 1.6 mg/dL (normal range <1.1mg/dL) at the first day and 1.4 mg/dL on the day of referral to our hospital. All other laboratory parameters were in the normal range. She arrived at 04:00 pm and a coronary angiogram with percutaneous coronary intervention (PCI) was scheduled for the next day 08:00 am. As a nephrology consultant, you are asked to give some data and recommendations concerning contrast-induced nephropathy (CIN) in this patient.
Question 1) - What is a common definition of contrast-induced nephropathy (CIN)? (chose the most appropriate answer)