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Publication Name
World Journal of Nephrology
ISSN
2220-6124
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study
Copyright: ©Author(s) 2026.
World J Nephrol. Jun 25, 2026; 15(2): 116961
Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.116961
Table 1 Baseline demographic and clinical characteristics of the studied group based on the development of contrast-associated acute kidney injury
Variables
CA-AKI (n = 20)
Non-CA-AKI (n = 135)
P value
Age (years)59.54 ± 8.6748.19 ± 7.890.001
Sex
    Male15 (75.0)95 (70.4)0.984
    Female5 (25.0)40 (29.6)
BMI (kg/m2)24.60 ± 4.4025.77 ± 3.110.870
Smoking4 (20.0)20 (14.8)0.756
Diabetes mellitus14 (70.0)100 (74.0)0.772
Hypertension6 (35.0)40 (29.6)0.161
Chest pain0.094
    Typical15 (75.0)108 (80.0)
    Atypical5 (25.0)27 (20.0)
Heart rate (beats/minute)80.46 ± 15.5182.11 ± 15.980.343
DBP (mmHg)90.90 ± 6.7889.11 ± 8.910.304
SBP (mmHg)118.56 ± 9.34117.78 ± 14.780.882
ECG findings 0.092
    Anterior infarction16 (80.0)108 (80.0)
    Inferior infarction2 (10.0)15 (11.1)
    Posterolateral infarction2 (10.0)12 (8.9)
    Prior PCI3 (15.0)20 (14.8)
Drug intake0.342
    ACE inhibitors8 (40.0)50 (37.0)0.650
    ARBs4 (20.0)35 (26.0)0.390
    Beta blocker16 (80.0)108 (80)0.090
    Loop diuretics6 (30.0)41 (30.4)0.210
    Nitrates10 (40.0)55 (40.7)0.780
    CCB5 (25.0)34 (25.2)0.570
    Statins16 (80.0)110 (81.5)0.070
    Aspirin17 (85.0)115 (85.2)0.330
    MRA2 (10.0)15 (11.1)0.710
Data are presented as mean ± SD or n (%). BMI: Body mass index; DBP: Diastolic blood pressure; SBP: Systolic blood pressure; ECG: Electrocardiogram; PCI: Percutaneous coronary intervention; ACE: Angiotensin-converting enzyme; CCB: Calcium channel blocker; MRA: Mineralocorticoid receptor antagonist; CA-AKI: Contrast-associated acute kidney injury; ARBs: Angiotensin II receptor blockers.
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Table 2 Laboratory findings in both groups of patients based on acute kidney injury
Variables
CA-AKI (n = 20)
Non-CA-AKI (n = 135)
P value
Blood count
    Hb (g/dL)11.25 ± 1.9711.16 ± 1.260.349
    Leucocytes (103/μL)9.86 ± 4.577.75 ± 5.430.098
    Platelets (103/μL)209.05 ± 74.13192.94 ± 98.510.238
Kidney function tests
    Serum creatinine (mg/dL)1.12 ± 0.091.09 ± 0.100.176
    Urea (mg)9.24 ± 2.178.18 ± 6.890.582
    eGFR (mL/minute/1.73 m2)99.84 ± 3.4197.77 ± 2.650.092
Liver function tests and markers
    ALT (U/L)22.28 ± 6.1125.70 ± 8.010.251
    AST (U/L)23.46 ± 8.8526.23 ± 9.150.972
    Bilirubin (mg/dL)0.71 ± 0.040.78 ± 0.020.221
    Albumin (g/dL)3.78 ± 0.483.80 ± 0.490.923
    Positive HCV antibodies02 (1.5)0.542
    Positive HBsAg1 (5.0)1 (0.8)0.813
    Glycosylated Hb (%)8.38 ± 0.986.45 ± 0.720.010
Lipid profile
    Cholesterol (mg/dL)197.60 ± 37.16171.93 ± 29.280.563
    HDL (mg/dL)45.64 ± 12.2154.32 ± 15.890.432
    LDL (mg/dL)103.79 ± 34.7895.13 ± 24.380.670
    Triglyceride (mg/dL)152.39 ± 54.46144.36 ± 35.400.581
Cardiac markers
    Troponin (ng/mL)8.11 ± 2.227.46 ± 3.300.762
    Creatine kinase (U/L)568.98 ± 123.78501.23 ± 1890.112
    CK-MB (ng/mL)15.55 ± 2.1914.90 ± 3.190.118
Data are presented as mean ± SD or n (%). eGFR: Estimated glomerular filtration rate; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; HCV: Hepatitis C virus; HBsAg: Hepatitis B virus surface antigen; Hb: Hemoglobin; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CK-MB: Creatine kinase MB; CA-AKI: Contrast-associated acute kidney injury.
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Table 3 Kidney function and osteopontin levels before and after the percutaneous coronary intervention in both groups of patients
Variables
CA-AKI (n = 20)
Non-CA-AKI (n = 135)
P value
Serum creatinine (mg/dL)
    Before1.12 ± 0.091.09 ± 0.100.170
    After1.89 ± 0.331.08 ± 0.180.001
Urea (mg)
    Before9.24 ± 2.178.18 ± 6.890.589
    After23.33 ± 5.667.54 ± 3.980.001
eGFR (mL/minute/1.73 m2)
    Before99.84 ± 3.4197.77 ± 2.650.093
    After79.55 ± 7.9999.11 ± 12.110.001
Osteopontin (ng/mL)
    Before76.11 ± 5.6822.90 ± 9.190.001
    After89.56 ± 14.5633.22 ± 8.560.001
Data are presented as mean ± SD. eGFR: Estimated glomerular filtration rate; CA: Contrast-associated; AKI: Acute kidney injury.
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Table 4 Echocardiography and angiographic data of both groups
Variables
CA-AKI (n = 20)
Non-CA-AKI (n = 135)
P value
Echocardiography
    Aortic valve area (cm)2.91 ± 0.452.89 ± 0.370.113
    LVEDD (cm)4.73 ± 0.605.07 ± 0.930.309
    LVESD (cm)3.53 ± 0.933.49 ± 0.720.750
    Ejection fraction (%)54.03 ± 3.7855.43 ± 5.400.262
    PASP (mmHg)29.11 ± 2.5628.90 ± 3.810.209
    LV diastolic dysfunction3 (15.0)12 (8.9)0.458
Type of PCI 0.230
    Elective16 (80.0)110 (81.5)
    Primary4 (20.0)25 (18.5)
Access0.873
    Femoral access17 (85.0)125 (92.6)
    Radial access3 (15.0)10 (7.4)
Type of contrast0.870
    Scanlux16 (80.0)110 (81.5)
    Ultravist3 (15.0)20 (14.8)
    Telebrix1 (5.0)5 (3.7)
Amount of contrast (mL)158.99 ± 29.88112.94 ± 25.950.001
Killip classes > II7 (35.0)41 (30.4)0.582
Culprit lesion0.708
    LAD15 (75.0)100 (74.0)
    RCA3 (15.0)20 (14.8)
    LCx2 (10.0)8 (6.0)
    Oblique marginal07 (5.2)
Data are presented as mean ± SD or n (%). LVEDD: Left ventricular end diastolic diameter; LVESD: Left ventricular end systolic diameter; PASP: Pulmonary artery systolic pressure; LV: Left ventricle; PCI: Percutaneous coronary intervention; LAD: Left anterior descending artery; RCA: Right coronary artery; LCx: Left circumflex artery; CA-AKI: Contrast-associated acute kidney injury.
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Table 5 Mehran risk scores of enrolled patients in both groups
Variables
CA-AKI (n = 20)
Non-CA-AKI (n = 135)
P value
Total score14.11 ± 3.484.90 ± 1.230.001
Class0.001
    Low risk0115 (85.2)
    Moderate risk1 (5.0)20 (14.8)
    High risk14 (70.0)0
    Very high risk5 (25.0)0
Data are presented as mean ± SD or n (%). CA-AKI: Contrast-associated acute kidney injury.
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Table 6 Correlations of osteopontin levels with other variables
VariablesBefore PCI
After PCI
r
P value
r
P value
Age (years)0.040.9800.110.870
Body mass index (kg/m2)0.100.4500.090.270
SBP (mmHg)-0.050.620-0.080.470
DBP (mmHg)-0.190.090-0.090.390
Hemoglobin (g/dL)-0.060.560-0.020.840
Leucocytes (103/μL)0.110.5600.130.490
Platelets (103/μL)0.090.200-0.100.510
Serum creatinine (mg/dL)0.450.0010.420.001
Blood urea (mg)0.230.0400.300.020
eGFR (mL/minute/1.73 m2)-0.330.030-0.420.001
Alanine aminotransferase (U/L)0.080.120-0.110.890
Aspartate aminotransferase (U/L)0.090.1200.190.110
Bilirubin (mg/dL)0.110.3100.010.070
Albumin (g/dL)0.210.560-0.070.090
Glycosylated hemoglobin (%)0.100.1900.210.610
Cholesterol (mg/dL)0.050.6500.140.200
High-density lipoprotein (mg/dL)0.140.2100.240.400
Low-density lipoprotein (mg/dL)-0.130.2300.010.990
Triglyceride (mg/dL)0.210.0600.060.580
Troponin (ng/mL)0.110.0900.070.100
Creatine kinase (U/L)0.090.1000.110.380
CK-MB (ng/mL)0.040.2200.100.180
Aortic valve area (cm)0.040.6900.010.900
LVEDD (cm)-0.010.870-0.210.060
LVESD (cm)0.120.5600.090.760
Ejection fraction (%)-0.180.210-0.110.590
PASP (mmHg)0.180.4500.170.110
Amount of contrast (mL)0.200.0900.110.210
Mehran score0.45< 0.0010.47< 0.001
Data are presented as mean ± SD or n (%). SBP: Systolic blood pressure; DBP: Diastolic blood pressure; eGFR: Estimated glomerular filtration rate; CK-MB: Creatine kinase MB; PASP: Pulmonary artery systolic pressure; LVEDD: Left ventricular end diastolic pressure; LVESD: Left ventricular end systolic pressure; PCI: Percutaneous coronary intervention.
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Table 7 Predictors of contrast-associated acute kidney injury in all patients
Predictors
Odds ratio
95%CI
P value
Age (years)1.211.30-7.890.434
Glycosylated hemoglobin (%)1.450.98-3.110.983
OPN before PCI3.222.56-8.180.001
OPN after PCI2.902.11-5.660.001
Contrast amount1.221.09-2.330.012
Mehran score3.102.22-7.890.001
OPN: Osteopontin; PCI: Percutaneous coronary intervention; CI: Confidence interval.
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Table 8 Accuracy of osteopontin and Mehran score in prediction of contrast-associated acute kidney injury
Indices
OPN before PCI
OPN after PCI
Mehran score
Mehran score with OPN before PCI
Mehran score with OPN after PCI
Sensitivity89.0%82.0%85.0%91.0%86.0%
Specificity85.0%79.0%83.0%88.0%82.0%
PPV82.3%75.5%43.0%53.1%41.0%
NPV90.8%84.6%97.0%98.0%97.0%
Accuracy86.8%80.3%83.3%88.0%82.0%
Cutoff point> 69.56> 75.00> 16.00
AUC0.800.700.800.950.80
P value0.0010.0010.0010.0010.001
PPV: Positive predictive value; NPV: Negative predictive value; AUC: Area under the curve; OPN: Osteopontin; PCI: Percutaneous coronary intervention.
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