Ji Ling, Su XiaoFeng, Qin Wei, Mi XuHua, Liu Fei, Tang XiaoHong, Li Zi, Yang LiChuan
West China Medical School of Sichuan University, Chengdu, China.
Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China.
Nephrology (Carlton). 2015 Aug;20(8):544-51. doi: 10.1111/nep.12429.
Contrast-induced nephropathy (CIN) post-percutaneous coronary intervention (PCI) is a major cause of acute kidney injury. In this study, we established a comprehensive risk score model to assess risk of CIN after PCI procedure, which could be easily used in a clinical environment.
A total of 805 PCI patients, divided into analysis cohort (70%) and validation cohort (30%), were enrolled retrospectively in this study. Risk factors for CIN were identified using univariate analysis and multivariate logistic regression in the analysis cohort. Risk score model was developed based on multiple regression coefficients. Sensitivity and specificity of the new risk score system was validated in the validation cohort. Comparisons between the new risk score model and previous reported models were applied.
The incidence of post-PCI CIN in the analysis cohort (n = 565) was 12%. Considerably high CIN incidence (50%) was observed in patients with chronic kidney disease (CKD). Age >75, body mass index (BMI) >25, myoglobin level, cardiac function level, hypoalbuminaemia, history of chronic kidney disease (CKD), Intra-aortic balloon pump (IABP) and peripheral vascular disease (PVD) were identified as independent risk factors of post-PCI CIN. A novel risk score model was established using multivariate regression coefficients, which showed highest sensitivity and specificity (0.917, 95%CI 0.877-0.957) compared with previous models.
A new post-PCI CIN risk score model was developed based on a retrospective study of 805 patients. Application of this model might be helpful to predict CIN in patients undergoing PCI procedure.
经皮冠状动脉介入治疗(PCI)后对比剂肾病(CIN)是急性肾损伤的主要原因。在本研究中,我们建立了一个综合风险评分模型来评估PCI术后CIN的风险,该模型可在临床环境中轻松应用。
本研究回顾性纳入了805例PCI患者,分为分析队列(70%)和验证队列(30%)。在分析队列中,采用单因素分析和多因素逻辑回归确定CIN的危险因素。基于多元回归系数建立风险评分模型。在验证队列中验证新风险评分系统的敏感性和特异性。对新风险评分模型与先前报道的模型进行比较。
分析队列(n = 565)中PCI术后CIN的发生率为12%。在慢性肾脏病(CKD)患者中观察到相当高的CIN发生率(50%)。年龄>75岁、体重指数(BMI)>25、肌红蛋白水平、心功能水平、低白蛋白血症、慢性肾脏病(CKD)病史、主动脉内球囊反搏(IABP)和外周血管疾病(PVD)被确定为PCI术后CIN的独立危险因素。使用多元回归系数建立了一个新的风险评分模型,与先前的模型相比,该模型显示出最高的敏感性和特异性(0.917,95%CI 0.877 - 0.957)。
基于对805例患者的回顾性研究,开发了一种新的PCI术后CIN风险评分模型。应用该模型可能有助于预测接受PCI手术患者的CIN。