The study assessed nutritional status using
the PNI method and found that those with low
PNI scores had significantly lower nutritional
status and a higher incidence of CIN. Coronary
angiography and PCI depend on the use of iodinated
intravascular contrast to observe blood vessels and
chambers. Although there have been improvements
in imaging and interventional procedures, the
use of iodinated contrast still has the potential to cause contrast-induced acute kidney damage in
some high-risk individuals.[
6] This disorder has a
complicated pathogenesis, with a prevalence reaching
up to 30%, and is linked to increased rates of both
short-term and long-term illness and death.[
7,
8]
Considering the clinical situation and features of
the patient, intravenous hydration should be taken
into account as a component of the treatment for ACS
patients with a low estimated glomerular filtration
rate who are scheduled for invasive management.
This is done to reduce the likelihood of CIN.[8-12]
In our study, patients with ACS were analyzed. In
these patients, it is recommended to use less contrast,
administer high-dose statin in the early period,
and provide intravenous hydration. Contrast-induced
nephropathy is usually transient in these patients, but
when dialysis is required, it can significantly impair
long-term outcomes. Therefore, predicting which
patients may develop CIN is important for post-PCI
treatment decisions.
Prior research has shown a correlation between
malnutrition and an increased susceptibility to
contrast-associated acute kidney injury during
PCI.[3] Hypoalbuminemia raises cardiovascular risk
primarily via the reduction of albumin's antioxidant,
oncotic pressure-maintaining, and antithrombotic
abilities.[13] Decreased absolute lymphocyte numbers
imply impaired immunological responses caused
by malnutrition.[14] Malnutrition scores have the
potential to aid in the categorization of risk and
evaluation of prognosis.
In 1984, Onodera et al.[13] evaluated the nutritional
and immunological condition of cancer patients
who were having gastrointestinal surgery. In recent
years, PNI has established recognition as a unique
prognostic marker for several illnesses, including
diabetic nephropathy, heart failure, and coronavirus
disease 2019.[15-24] To our knowledge, this is the first
study in the literature investigating the relationship
between nutritional status and the development of
contrast nephropathy in patients with ACS.
This study had several limitations, the primary
one being its retrospective and single-center design.
Additionally, the PNI's ability to predict nutritional
status was similarly restricted. There may be
variations in nutritional indices among various ethnic
communities. As the PNI was generated using the
original reference values, we did not have information
about the changes in the nutritional values of the patients. Prospective studies are necessary to
determine the effect of dietary status on CIN in
individuals with ACS.
In conclusion, this study demonstrated that PNI, a
marker of nutritional status, may be a reliable predictor
of contrast nephropathy in patients presenting with
ACS. A low PNI score indicates an inadequate
nutritional status, which is thought to accelerate
inflammatory processes and lead to acute kidney
injury.
Data Sharing Statement: The data that support the
findings of this study are available from the corresponding
author upon reasonable request.
Conflict of Interest: The author declared no conflicts of
interest with respect to the authorship and/or publication of
this article.
Funding: The author received no financial support for the
research and/or authorship of this article.
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