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Mehran Score for Post-PCI Contrast Nephropathy

Predicts risk of contrast-induced nephropathy and need for dialysis after percutaneous coronary intervention.

Mehran Score for Post-PCI Contrast Nephropathy
Hypotension (SBP <80 mmHg for >=1 hour needing inotropes/IABP within 24h periprocedure)
Intra-aortic balloon pump use
Congestive heart failure (NYHA class III/IV or history of pulmonary edema)
Age >75 years
Anemia (baseline hematocrit <39% men / <36% women)
Diabetes mellitus
Contrast media volume
mL
Estimated GFR
mL/min/1.73m2
Complete the fields above to see the result.

When to use

  • Estimating risk of contrast-induced nephropathy and dialysis before or after percutaneous coronary intervention to guide preventive strategies (hydration, minimizing contrast volume).

Formula

Sum of: hypotension (5), IABP (5), CHF (5), age >75 (4), anemia (3), diabetes (3), contrast volume/100 mL (1 point per 100 mL), and eGFR-based points (0 if >=60, 2 if 40-59, 4 if 20-39, 6 if <20 mL/min/1.73m2). Score bands: <=5, 6-10, 11-15, >=16.

Pearls and pitfalls

  • Developed and validated in an era of high-osmolar and low-osmolar contrast; absolute risk with modern iso-osmolar agents and current definitions of AKI may be lower.
  • Minimizing contrast volume and periprocedural hydration are the main modifiable levers.

References

  1. Mehran R, Aymong ED, Nikolsky E, et al. J Am Coll Cardiol. 2004;44(7):1393-9.