The association between metformin use and contrast-induced nephropathy in diabetic patients undergoing coronary angiography

Arzu Akgül; Çağatay Tunca; Mehmet Deniz Aylı

Makale detayları

The association between metformin use and contrast-induced nephropathy in diabetic patients undergoing coronary angiography

Yazarlar:

Arzu Akgül | Çağatay Tunca | Mehmet Deniz Aylı

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Nefroloji

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 4, pp.305-310

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357449

pISSN:

2717-7505

Anahtar kelimeler:

Özet:

 Aims: Contrast-induced nephropathy CIN is a significant cause of hospital-acquired acute kidney injury, particularly in patients with diabetes mellitus undergoing coronary angiography. Although metformin is a widely prescribed antidiabetic agent, its role in CIN prevention remains controversial. This study aimed to investigate the impact of metformin use on the development of CIN in diabetic patients undergoing coronary angiography. Methods: This retrospective cohort study included 398 diabetic patients undergoing coronary angiography with a diagnosis of acute coronary syndrome between November 2022 and December 2024. Patients were classified into two groups based on metformin use metformin group, n122; non-metformin group, n276. CIN was defined as a 25 or 0.5 mgdl increase in serum creatinine within 48 hours post-procedure. Demographic, clinical, laboratory, and procedural data were analyzed. Multivariate logistic regression was used to identify independent predictors of CIN. Results: CIN occurred in 6.6 of patients in the metformin group and 20.3 in the non-metformin group p0.001. Metformin use was independently associated with a lower risk of CIN OR: 0.31; 95 CI: 0.140.69; p0.004 in the multivariate logistic regression analysis. Other independent predictors of CIN included age 65 years, chronic kidney disease, high glucose, hemoglobin, CRP, smoking, and contrast volume. Conclusion: Metformin use is does not increase the risk of CIN in diabetic patients undergoing coronary angiography. These findings support the potential renoprotective effect of metformin and question the necessity of routinely discontinuing it before contrast administration in patients with preserved renal function.

 Aims: Contrast-induced nephropathy CIN is a significant cause of hospital-acquired acute kidney injury, particularly in patients with diabetes mellitus undergoing coronary angiography. Although metformin is a widely prescribed antidiabetic agent, its role in CIN prevention remains controversial. This study aimed to investigate the impact of metformin use on the development of CIN in diabetic patients undergoing coronary angiography. Methods: This retrospective cohort study included 398 diabetic patients undergoing coronary angiography with a diagnosis of acute coronary syndrome between November 2022 and December 2024. Patients were classified into two groups based on metformin use metformin group, n122; non-metformin group, n276. CIN was defined as a 25 or 0.5 mgdl increase in serum creatinine within 48 hours post-procedure. Demographic, clinical, laboratory, and procedural data were analyzed. Multivariate logistic regression was used to identify independent predictors of CIN. Results: CIN occurred in 6.6 of patients in the metformin group and 20.3 in the non-metformin group p0.001. Metformin use was independently associated with a lower risk of CIN OR: 0.31; 95 CI: 0.140.69; p0.004 in the multivariate logistic regression analysis. Other independent predictors of CIN included age 65 years, chronic kidney disease, high glucose, hemoglobin, CRP, smoking, and contrast volume. Conclusion: Metformin use is does not increase the risk of CIN in diabetic patients undergoing coronary angiography. These findings support the potential renoprotective effect of metformin and question the necessity of routinely discontinuing it before contrast administration in patients with preserved renal function.

 Aims: Contrast-induced nephropathy CIN is a significant cause of hospital-acquired acute kidney injury, particularly in patients with diabetes mellitus undergoing coronary angiography. Although metformin is a widely prescribed antidiabetic agent, its role in CIN prevention remains controversial. This study aimed to investigate the impact of metformin use on the development of CIN in diabetic patients undergoing coronary angiography. Methods: This retrospective cohort study included 398 diabetic patients undergoing coronary angiography with a diagnosis of acute coronary syndrome between November 2022 and December 2024. Patients were classified into two groups based on metformin use metformin group, n122; non-metformin group, n276. CIN was defined as a 25 or 0.5 mgdl increase in serum creatinine within 48 hours post-procedure. Demographic, clinical, laboratory, and procedural data were analyzed. Multivariate logistic regression was used to identify independent predictors of CIN. Results: CIN occurred in 6.6 of patients in the metformin group and 20.3 in the non-metformin group p0.001. Metformin use was independently associated with a lower risk of CIN OR: 0.31; 95 CI: 0.140.69; p0.004 in the multivariate logistic regression analysis. Other independent predictors of CIN included age 65 years, chronic kidney disease, high glucose, hemoglobin, CRP, smoking, and contrast volume. Conclusion: Metformin use is does not increase the risk of CIN in diabetic patients undergoing coronary angiography. These findings support the potential renoprotective effect of metformin and question the necessity of routinely discontinuing it before contrast administration in patients with preserved renal function.

 Amaç: Bu çalışmada, metformin kullanımının koroner anjiyografi uygulanan tip 2 diyabetik hastalarda kontrast indüklü nefropati CIN gelişimi üzerine etkisini incelemeyi amaçladık. Yöntem: Kasım 2022-Aralık 2024 tarihleri arasında akut koroner sendrom tanısıyla koroner anjiyografi uygulanan 398 diyabetik hasta metformin kullanan n122, kullanmayan n276 çalışmaya dahil edildi. Hastalar demografik, klinik ve laboratuvar özellikleri açısından karşılaştırıldı. CIN, işlemden sonraki 48 saat içinde serum kreatinin seviyesinde bazal değere göre 25 veya 0.5 mgdL artış olarak tanımlandı. Tüm hastalara işlem öncesi oral hidrasyon ve sonrasında intravenöz sıvı uygulandı. Bulgular: Metformin kullanan grupta CIN gelişme oranı 6.6 iken, kullanmayan grupta 20.3 olarak saptandı p0.001. Ortalama kontrast madde hacmi metformin kullanan grupta 290.0 mL 220.0-320.0, kullanmayan grupta 280.0 mL 210.0-310.0 olarak saptandı p0.095. Çok değişkenli lojistik regresyon analizinde metformin kullanımının CIN gelişme riskini anlamlı şekilde azalttığı gösterildi OR: 0.31, 95 CI: 0.14-0.69, p0.004. Diğer bağımsız risk faktörleri arasında 65 yaş üstü olmak OR: 2.43, p0.001, GFR60 mLdk1.73m² OR: 2.48, p0.001, CRP10 mgL OR: 2.12, p0.001 ve hemoglobin12 gdL OR: 1.92, p0.001 yer aldı. Sonuç: Metformin kullanımı, koroner anjiyografi uygulanan diyabetik hastalarda CIN gelişme riskini önemli ölçüde azaltmaktadır. Bu bulgular, metforminin kontrast prosedürler öncesinde rutin olarak kesilmesi yaklaşımının yeniden değerlendirilmesi gerektiğini göstermektedir.

Makale detayları

The association between metformin use and contrast-induced nephropathy in diabetic patients undergoing coronary angiography

Yazarlar:

Arzu Akgül | Çağatay Tunca | Mehmet Deniz Aylı

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Nefroloji

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 4, pp.305-310

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357449

pISSN:

2717-7505

Contrast-induced nephropathy

metformin

diabetes mellituskontrast nefropati

diyabetes mellitus

metformin

Sayı

Makale detayları

The association between metformin use and contrast-induced nephropathy in diabetic patients undergoing coronary angiography

Yazarlar: Arzu Akgül | Çağatay Tunca | Mehmet Deniz Aylı

Yayıncı: MediHealth Academy Yayıncılık

Ana Başlıklar: Nefroloji

Dergi: Journal of Medicine and Palliative Care Vol.6 Issue 4, pp.305-310

Belge Tipi: Makale

Yayın Tarihi: 8/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001357449

pISSN: 2717-7505

Contrast-induced nephropathy

metformin

diabetes mellituskontrast nefropati

diyabetes mellitus

metformin

Sayı

Yazarlar:

Arzu Akgül | Çağatay Tunca | Mehmet Deniz Aylı

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Nefroloji

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 4, pp.305-310

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357449

pISSN:

2717-7505