A Novel Biomarker to Predict Contrast-Induced Nephropathy and the Requirement for Renal Replacement Therapy in Patients Undergoing Coronary Angiography: C-PEPTIDE/HBA1C

Contrast-induced nephropathy (CIN) is a major cause of mortality and morbidity with an increasing incidence after coronary angiography (CAG). For this reason, it is important to identify subjects who are prone to CIN in advance and to take intensive protective measures accordingly. In this study, we aimed to reveal the role of C-peptide, HbA1c and C-peptide/HbA1c (CHR) ratio for predicting CIN development and the requirement for renal replacement therapy (RRT) in patients undergoing CAG. A total of 2,271 patients who underwent CAG between January 2019 and June 2021 were included in this prospective observational study. C-peptide and HbA1c levels were measured in all patients who underwent CAG, whether they were diabetic or not. We attempted to identify independent predictors for the development of CIN. In addition, patients who needed RRT after CIN were followed up for an average of 90 days. In a multivariate analysis, CHR was determined as an independent predictor of CIN and identified as an independent risk factor for the requirement for RRT in patients undergoing CAG. The main finding of our study was the fact that we identified CHR as an independent predictor for the development of CIN and the need for RRT in patients undergoing CAG.