Mehran Score for Post-PCI Contrast Nephropathy
Mehran Calculator
Hypotension (SBP <80 mmHg or IABP/inotropes for ≥1 hr)
Intra-aortic Balloon Pump (IABP)
Congestive Heart Failure (NYHA III-IV or Hx of Pulmonary Edema)
Age >75 Years
Anemia (Hct <39% for men, <36% for women)
Diabetes Mellitus
mL (+1 per 100 mL)
eGFR (mL/min/1.73m²)
Mehran Score:
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Predicts risk of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI).
When to Use
Use in patients undergoing PCI. Do not use in patients with pre-existing end-stage renal disease on dialysis or patients with contrast exposure within 1 week of the index procedure.
Formula
Addition of the selected points: Variable Points Hypotension* No 0 Yes 5 Intra-aortic balloon pump No 0 Yes 5 Congestive heart failure** No 0 Yes 5 Age >75 years No 0 Yes 4 Anemia*** No 0 Yes 3 Diabetes No 0 Yes 3 Contrast media volume - 1 point per 100 mL contrast eGFR , mL/min/1.73 m 2 ≥60 0 40 to <60 2 20 to <40 4 <20 6 *Systolic blood pressure <80 mmHg for at least 1 hour requiring inotropic support with medications or intra-aortic balloon pump within 24 hours periprocedurally. **CHF class III/IV by New York Heart Association Classification and/or history of pulmonary edema. ***Baseline hematocrit value <39% for men and <36% for women. Note: the original study includes serum creatinine (as a dichotomous variable) as an alternative to eGFR, and adds 4 points for Cr >1.5 mg/dL. We have chosen to use eGFR in this calculator as it tends to be a more accurate measure of renal function than creatinine alone.
Pearls / Pitfalls
In the original study , “contrast-induced nephropathy” was defined as an increase ≥0.5 mg/dL (or ≥25%) in pre-PCI serum creatinine at 48 hours post-PCI.
Advice
Consider renal protective measures such as N-acetylcysteine and limiting contrast volume in patients at high risk of CIN.
More Information
Interpretation: CIN Risk Score Risk of post-PCI CIN Any CIN CIN requiring dialysis ≤5 7.5% 0.04% 6-10 14.0% 0.12% 11-15 26.1% 1.09% ≥16 57.3% 12.6%