LAUSR

We thank Ozcan Cetin et al for their interest in our article. Stated in their letter, we found a relationship between fibrinogen to albumin ratio and contrast-induced nephropathy (CIN) in patients who underwent carotid angiography. Blood viscosity is a major determinant of blood flow. Whole blood viscosity is determined by the complex interactions of blood constituents, including red blood cells, white blood cells, platelets, fibrinogen, and other plasma proteins, such as albumin. An increase in whole blood viscosity was found to be a predictor for various cardiovascular disease. There may be an association between increased fibrinogen to albumin ratio and hemoconcentration. We did not measure blood viscosity. The European Society of Cardiology guidelines recommend to assess the total contrast medium volume to glomerular filtration rate ratio to predict the risk of CIN. However, this ratio was not calculated in our study. A decrease in albumin level is more frequent in heart failure. These patients have a high risk for the development of CIN. Unfortunately, we did not evaluate these patients separately in terms of CIN. We agree that it would be useful to evaluate whole blood viscosity for predicting CIN in patients who underwent carotid angiography.