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Full Blood Count as a Potential Predicting Factor of Contrast-Induced Nephropathy After Endovascular Aortic Aneurysm Repair

Contrast-induced nephropathy (CIN) is an important adverse effect of administration of intravenous contrast agent (CA) associated with prolonged hospitalization as well as increased cardiovascular and renal morbidity and all-cause mortality. Several risk factors can predict CIN incidence, and various scores have been proposed to identify high-risk patients prior to CA exposure. Endovascular aortic aneurysm repair (EVAR) requires CA for the preinterventional computed tomography (CT), during the procedure and the follow-up period when using CT. Clinical assessment of kidney function is a routine practice pre-EVAR because the incidence of acute kidney injury after EVAR is significant and is independently associated with medium-term mortality and morbidity. The complete blood count, a readily available, routine examination, has been considered as an indicator of CIN in cardiology patients. The neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and red cell distribution width have been suggested as predictors of CIN in patients undergoing cardiologic interventional procedure. Considering the common pathway between pathophysiology and risk profiles in coronary artery disease and abdominal aortic aneurysm, we suggest that a complete blood count could be used to identify patients who are at high risk of CIN after EVAR. Future prospective studies should assess the potential usefulness of the complete blood count in the identification of patients at high risk to develop post-EVAR CIN. This may guide the need for intense preprocedural preventive strategy.