TO STUDY THE CORRELATION OF THE NEUTROPHIL TO LYMPHOCYTE RATIO AND C-REACTIVE PROTEIN TO ALBUMIN RATIO WITH CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTIONS

Abstract

Background

CIN (Contrast-Induced Nephropathy) is a form of acute kidney injury that arises following exposure to iodinated contrast media, particularly during PCI (Percutaneous Coronary Interventions). CIN is associated with increased morbidity, prolonged hospitalization, and adverse cardiovascular outcomes. Inflammatory markers such as the NLR (Neutrophil-to-Lymphocyte Ratio) and CAR (C-Reactive Protein to Albumin Ratio) have recently been proposed as potential predictors of CIN.

 Methods

This prospective observational study was conducted at Dr. D.Y. Patil Medical College Hospital, Mumbai, between 2023 and 2024, enrolling 100 patients undergoing PCI. Baseline demographics, comorbidities, and laboratory parameters including NLR and CAR were recorded. CIN was defined as a ≥0.5 mg/dL or ≥25% rise in serum creatinine within 48–72 hours post-contrast exposure. Data were analyzed using appropriate statistical methods including chi-square, t-tests, and multivariate regression.

 Results

CIN occurred in 14% of patients. A statistically significant association was observed between CIN and hypertension (p = 0.021), elevated blood sugar levels (p = 0.0378), low hemoglobin (p = 0.0041), low lymphocyte count (p = 0.0400), high neutrophil count (p = 0.0024), and increased CRP levels (p < 0.001). Mean NLR was significantly higher in the CIN group (6.58 ± 4.69 vs. 4.27 ± 3.42, p = 0.0289), and CAR was also notably elevated (2.06 ± 2.13 vs. 0.53 ± 0.61, p < 0.001).

 Conclusion

The findings suggest that elevated NLR and CAR values are significantly associated with the incidence of CIN in patients undergoing PCI. These inflammatory markers can serve as simple, cost-effective tools for early identification and risk stratification of patients at risk for CIN.