The association between contrast associated acute kidney injury and direct bilirubin levels

Abstract

Aim: In this study we aimed to association between bilirubin levels, which is known to have anti-oxidative, anti-inflammatory and anti-thrombotic effects, and contrast associated acute kidney injury (CA-AKI) in patients with acute coronary syndrome (ACS). Methods: Between 2017-2020, consecutive patients over 18 years of age who applied percutaneous angioplasty with the ACS diagnosis and met the exclusion and inclusion criteria (n:514) were retrospectively screened. Age, gender, chronic diseases and complete blood count parameters of the cases were recorded. Biochemical parameters, before applying contrast and 48 hours after applying contrast, were recorded. A 25% increase in creatinine level measured 48 hours after contrast application compared to basal creatinine was defined as CA-AKI. Results: CA-AKI rate was higher in females(p=0.011). In the CA-AKI positive patient group, the mean age was found significantly higher (p=0.04), hemoglobin (p=0.007), direct bilirubin (p=0.008) levels were found significantly lower. Direct bilirubin was found to be a predictor as a result of our statistical analysis to identify independent predictors of CA-AKI (Beta:0.051 OR 95% CI:0.007-0.392, p=0.004). It was found that the direct bilirubin value of 0.065 predicted CA-AKI with 90% sensitivity and 91% specificity. Conclusions: It was observed that the direct bilirubin values were significantly lower in the CA-AKI positive patient group, and the direct bilirubin value of 0.065 predicted CA-AKI with 90% sensitivity and 91% specificity.