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Mehran Score for CIN (Contrast-Induced Nephropathy)

Calculates risk of kidney damage and dialysis requirement post-PCI or angiography using the Mehran integer score.

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Category Medicine & Tests
Clinical Factors
Kidney Function & Procedure
1 point per 100mL
Calculated eGFR Estimate: -- mL/min
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About

Contrast-Induced Nephropathy (CIN) is a leading cause of hospital-acquired acute kidney injury, particularly following percutaneous coronary intervention (PCI). The Mehran Score is the validated risk prediction model used by interventional cardiologists to assess the probability of nephropathy before administering contrast media.

This tool aggregates modifiable and non-modifiable variables-such as contrast volume, hypotension, and pre-existing renal dysfunction-into a cumulative integer score. The output estimates both the risk of CIN (defined as ≥ 25% increase in serum creatinine) and the risk of requiring hemodialysis. High scores necessitate prophylactic hydration strategies and minimization of dye volume.

nephrology cardiology kidney failure angiography contrast dye

Formulas

The Mehran Score S is calculated by summation:

S = Hypotension(5) + IABP(5) + CHF(5) + Age>75(4) + Anemia(3) + Diabetes(3) + Contrast Vol + eGFR Score

Specific sub-calculations:

{
Contrast Volume: 1 pt per 100mLeGFR 40-60: 2 ptseGFR 20-40: 4 ptseGFR <20: 6 pts

Reference Data

Mehran Risk ScoreRisk ClassRisk of CIN (%)Risk of Dialysis (%)
≤ 5Low7.5%0.04%
6 - 10Moderate14.0%0.12%
11 - 15High26.1%1.09%
≥ 16Very High57.3%12.6%

Frequently Asked Questions

Hypotension is defined as a systolic blood pressure below 80 mmHg for at least one hour requiring inotropic support or fluid resuscitation.
Contrast volume is a modifiable risk factor. While the score assigns 1 point for every 100mL, clinical data suggests keeping the ratio of Contrast Volume to Creatinine Clearance (V/CrCl) below 3.7 significantly reduces the risk of injury.
For the Mehran score, anemia is baseline hematocrit < 39% for men and < 36% for women.
The Mehran score was specifically derived from patients undergoing intra-arterial administration (PCI). While often used for risk stratification in IV contrast CT scans, the predictive value is lower, as IV contrast generally carries a lower risk of CIN than intra-arterial procedures.