MICROALBUMINURIA ELEVATED IN PREDIABETIC& DIABETIC CAD PATIENTS FOLLOWING PCI
Aim: To evaluate incidence of contrast induced nephropathy (CIN) following Percutaneous intervention (PCI) by changes in serum creatinine and involvement of microalbumin & urine microalbumin per gm creatinine in diabetic and prediabetic patients. In India 30% of population have risk factors of CAD, PCI and coronary angiogram remains the gold standard. Iatrogenic renal function impairment from exposure to contrast media (CM) is unclear. Study to observe effect on serum creatinine levels and microalbumin in urine of CAD patients undergoing PCI having normal renal function, and the association with age, diabetes, for effect of volume of contrast media, to identify CIN & microalbuminuria is taken up with preprocedure levels as control. Method: 70 CAD patients having normal renal function selected for PCI, 39 prediabetic & diabetic, 21 normal, Pre- procedure blood & urine samples taken as control, Using Hitachi 912 assays for microalbumin & creatine, an absolute increase of 0.5 mg/dl serum creatinine, at 48 and72 hours following exposure to CM as accepted definition of CIN is taken, urine microalbumin per gm creatinine was calculated & contrast volume measured. Results: In this study, serum creatinine levels, urine microalbumin and microalbumin per gm creatinine levels.showed risk of CIN 16.7%. In the non diabetic microalbuminuria sample A B, C was 7.05±2.05,10.68±3.29, and13.33±4.25 and in diabetics it was15.14±5.02, 30.01±9.77 and 52.72±8.22 significance 0.034*. Conclusion: At risk for CIN is 16.7%. The relation between urine microalbumin in diabetic and non diabetic was (p< 0.034) and microalbumin per gm creatinine (p=0.049) Thus elevation post procedure is significant.