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For healthcare professionals

Mehran score calculator

The Mehran risk score adds points for eight clinical and procedural factors to estimate the risk of contrast-induced nephropathy, a rise in creatinine after the contrast dye used in percutaneous coronary intervention (PCI). This tool is written for clinicians and is not a diagnosis.

Last reviewed: By the uncovermyrisk.com editorial team Educational only, not medical advice.

Chest pain, fainting, severe breathlessness or passing almost no urine after a heart procedure: call 911 now.General safety advice (not part of the published score/formula). Do not wait for a score.

Patient and procedure

Answer for the current procedure. Nothing you enter leaves this page.

Hypotension (systolic pressure under 80 mmHg for at least 1 hour needing inotropes or a balloon pump)
Intra-aortic balloon pump
Congestive heart failure (NYHA class III or IV, or a history of pulmonary oedema)
Anaemia (haematocrit under 39% in men, under 36% in women)
Diabetes
Kidney measure
Result appears here

What you will see

The total Mehran score with the points for each factor, the risk group (5 or less, 6 to 10, 11 to 15, 16 or more) and the nephropathy and dialysis rates printed for that group.

Educational only, not medical advice. Not a diagnosis. Decisions belong to the treating team.

Source

The risk score by Mehran R and colleagues, Journal of the American College of Cardiology 2004, with the points and group rates as printed in the open access tables of Samir and colleagues, Egyptian Heart Journal 2023 (Table 1), and Reyes and colleagues, BMC Nephrology 2020 (Table 1), and the group edges as printed by Arrotti and colleagues 2023 and Gupta and colleagues 2024 (all CC BY 4.0). The tests check each item, every printed eGFR and creatinine edge, the contrast steps and the 6, 11 and 16 group edges.

Validated in

Patients having percutaneous coronary intervention, the setting the score was developed in, as the open sources describe it. Arrotti and colleagues tested it in 1,180 patients having transcatheter aortic valve implantation (TAVI), where the balloon pump and hypotension items were scored 0. We do not describe the original paper further, because it is not open access.

Limits

The rates are those seen in the four groups of the 2004 study, not a personal prediction, and later studies report varying accuracy. The open tables print the eGFR bands as 60 to 40, 40 to 20 and under 20 and list no points above 60; one source labels the item eGFR under 60. eGFR exactly 60 or 40 therefore shows both readings. Contrast scores 1 point for every 100 mL; a part of 100 mL is shown both ways. Samir and colleagues print the group edges as under 5, 6 to 10, 11 to 16 and over 16; we use 5 or less, 6 to 10, 11 to 15 and 16 or more, as Arrotti and colleagues and Gupta and colleagues print them. Gupta and colleagues print 26.0% for the high group, where Samir and colleagues print 26.1%.

The point table

Mehran risk score, as printed in Samir and colleagues 2023, Table 1 (Samir 2023), with the creatinine option from Reyes and colleagues 2020, Table 1 (Reyes 2020) (Mehran 2004):

Gupta and colleagues define the hypotension item as a systolic pressure under 80 mmHg for at least 1 hour needing inotropes or a balloon pump within 24 hours of the procedure (Gupta 2024).

Worked example: a 78-year-old (4) with diabetes (3), eGFR 35 (4) and 250 mL of contrast (2 for the two full 100 mL steps, 3 if the part counts) and none of the other factors scores 13 or 14 points, the high group either way.

Reading the result

Patients are grouped as low (5 or less), moderate (6 to 10), high (11 to 15) and very high (16 or more) risk (Arrotti 2023) (Gupta 2024). As printed by Samir and colleagues, the contrast-induced nephropathy risk in these groups was 7.5%, 14%, 26.1% and 57.3%, and the dialysis risk 0.04%, 0.12%, 1.09% and 12.6% (Samir 2023). In a prospective study of 55 high-risk patients, Gupta and colleagues found contrast-induced nephropathy in 6 of the 21 patients in the low group (28.6%), against the 7.5% printed for that group, so the score is an aid to judgment, not a test on its own (Gupta 2024). To estimate kidney function first, use the eGFR calculator or the creatinine clearance calculator.

Related tools

For kidney function, see the eGFR calculator, the creatinine clearance calculator and the BUN to creatinine ratio calculator; for kidney injury once it has happened, the FENa calculator; for in-hospital bleeding risk in NSTEMI, the CRUSADE bleeding score. Other bedside scores are listed under For healthcare professionals.

Sources

  1. Samir A, Gabra W, Alhossary H, Bakhoum S. Predictive value of CHA2DS2VASC score for contrast-induced nephropathy after primary percutaneous coronary intervention for patients presenting with acute ST-segment elevation myocardial infarction. Egypt Heart J. 2023;75(1):52. doi:10.1186/s43044-023-00378-x. PMID 37358644. Open access (CC BY 4.0). Table 1 (Mehran risk score points, CIN and dialysis risk by group). pmc.ncbi.nlm.nih.gov/articles/PMC10293538/
  2. Reyes LF, Severiche-Bueno DF, Bustamante CA, Murillo S, Soni NJ, Poveda M, Gomez E, Buitrago R, Rodriguez A. Serum levels of neutrophil gelatinase associated lipocalin (NGAL) predicts hemodialysis after coronary angiography in high risk patients with acute coronary syndrome. BMC Nephrol. 2020;21(1):143. doi:10.1186/s12882-020-01799-5. PMID 32321453. Open access (CC BY 4.0). Table 1 (Mehran risk score, creatinine and eGFR options). pmc.ncbi.nlm.nih.gov/articles/PMC7178579/
  3. Arrotti S, Sgura FA, Monopoli DE, Siena V, Leo G, Morgante V, Cataldo P, Magnavacchi P, Gabbieri D, Guiducci V, Benatti G, Vignali L, Boriani G, Rossi R. The importance of Mehran score to predict acute kidney injury in patients with TAVI: a large multicenter cohort study. J Cardiovasc Dev Dis. 2023;10(6):228. doi:10.3390/jcdd10060228. PMID 37367393. Open access (CC BY 4.0). Methods (risk groups). pmc.ncbi.nlm.nih.gov/articles/PMC10298873/
  4. Gupta H, Singh MM, Sahani KK, Gupta A, Seth G. Evaluation of emerging predictors for contrast-induced nephropathy in high-risk patients undergoing percutaneous coronary intervention. Cureus. 2024;16(7):e64363. doi:10.7759/cureus.64363. PMID 39130830. Open access (CC BY 4.0). Table 3, Table 4 and results. pmc.ncbi.nlm.nih.gov/articles/PMC11316681/
  5. Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, Mintz GS, Lansky AJ, Moses JW, Stone GW, Leon MB, Dangas G. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44(7):1393-1399. doi:10.1016/j.jacc.2004.06.068. PMID 15464318. Original score (cited, not quoted). pubmed.ncbi.nlm.nih.gov/15464318/

Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-03. Spotted an error? See About.