Predictors and Consequenses of Contrast Induced Nephropathy in Northeast Nigeria: A Call for Caution in Iodinated Contrast Procedures

Contrast-induced nephropathy (CIN) remains a significant clinical concern worldwide, recognized as the third leading cause of acute kidney injury (AKI) in developed countries. Defined as an acute increase in serum creatinine greater than 0.5 mg/dL above baseline or a 25% rise within 48 to 72 hours following contrast media (CM) administration, CIN's prevalence and patterns vary across different settings. The advent of novel kidney biomarkers, such as serum cystatin C, has enhanced the detection of contrast-related AKI, yet limited data exist from regions like Northeast Nigeria. This study aimed to evaluate the predictors, clinical patterns, and short-term renal outcomes of CIN using both serum cystatin C and creatinine among patients undergoing contrast procedures at the University of Maiduguri Teaching Hospital (UMTH). Methods: A prospective cohort study was conducted involving 150 consenting adult patients (aged ≥18 years) referred for contrast-enhanced investigations at UMTH. Sociodemographic data were collected, and blood samples analyzed for serum cystatin C and creatinine levels. Estimated glomerular filtration rate (eGFR) was calculated using CKD-EPI equations. CIN was diagnosed based on established criteria, and the prevalence, risk factors, and outcomes were assessed. Statistical significance was set at p<0.05. Results: The prevalence of CIN was 30% (45 patients) when assessed via serum creatinine at 48 hours, and 49.3% (74 patients) using serum cystatin C at 24 hours. Significant predictors of CIN included advancing age (OR=1.346, P=0.009), higher contrast volume (OR=2.037, P=0.001), elevated baseline serum creatinine (OR=1.601, P=0.006), and reduced baseline eGFR (OR=1.767, P=0.003). The diagnostic performance of cystatin C demonstrated sensitivities of 53.3% at 24 hours, increasing to 68% at 48 hours, but it was not more sensitive or specific than serum creatinine. Among patients with CIN, 73.3% experienced complete renal recovery within two weeks, while