Mironova O I, Staroverov I I, Sivakova O A, Deev A D, Fomin V V
Sechenov First Moscow State Medical University (Sechenov University).
National Medical Research Center of Cardiology.
Ter Arkh. 2020 Nov 24;92(10):29-33. doi: 10.26442/00403660.2020.10.000753.
To assess the influence of diabetes mellitus and obesity on contrast-induced acute kidney injury risk in patients with chronic coronary artery disease requiring percutaneous coronary intervention.
1023 patients with chronic coronary artery disease were enrolled in a prospective, open, cohort study (ClinicalTrials.gov ID NCT04014153). Contrast-induced acute kidney injury was defined as an increase of 25% or more, or an absolute increase of 0.5 mg/dl or more in serum creatinine from baseline value, assessed at 48 hours following the administration of the contrast. The majority of the patients were overweight male ones with BMI 29.25.5 kg/m2. The primary endpoint of the study was the development of contrast-induced acute kidney injury according to KDIGO criteria.
The prevalence of contrast-induced acute kidney injury was 12.9% (132 patients). 21.2% suffered from diabetes mellitus, 43% were obese and 12.9% had both diabetes mellitus and obesity. Diabetes wasnt a statistically significant independent risk factor of the contrast-induced acute kidney injury, as well as the combination of diabetes and obesity. In the group of obese patients the prevalence of contrast-induced acute kidney injury was higher (13.4%vs12.5%), but didnt meet statistical significance (p=0.7, OR 0.924, 95% CI 0.641.325). According to the multiple logistic regression model, female gender, age, BMI, weight, arterial hypertension, baseline creatinine were the risk factors of the contrast-induced acute kidney injury development (AUC 0.742,p0.0001).
Diabetes mellitus was not associated with higher incidence of contrast-induced acute kidney injury. The prevalence of contrast-induced kidney injury was higher in the group of patients with BMI30 kg/m2, but didnt meet statistical significance and needs further evaluation in larger studies.
评估糖尿病和肥胖对需要经皮冠状动脉介入治疗的慢性冠状动脉疾病患者造影剂诱导的急性肾损伤风险的影响。
1023例慢性冠状动脉疾病患者纳入一项前瞻性、开放性队列研究（ClinicalTrials.gov标识符NCT04014153）。造影剂诱导的急性肾损伤定义为造影剂给药后48小时血清肌酐较基线值升高25%或更多，或绝对升高0.5mg/dl或更多。大多数患者为超重男性，体重指数为29.2±5.5kg/m²。该研究的主要终点是根据KDIGO标准发生造影剂诱导的急性肾损伤。
造影剂诱导的急性肾损伤患病率为12.9%（132例患者）。21.2%患有糖尿病，43%肥胖，12.9%同时患有糖尿病和肥胖。糖尿病以及糖尿病与肥胖的组合不是造影剂诱导的急性肾损伤的统计学显著独立危险因素。在肥胖患者组中，造影剂诱导的急性肾损伤患病率较高（13.4%对12.5%），但未达到统计学显著性（p=0.7，OR 0.924，95%CI 0.64-1.325）。根据多因素逻辑回归模型，女性、年龄、体重指数、体重、动脉高血压、基线肌酐是造影剂诱导的急性肾损伤发生的危险因素（AUC 0.742，p<0.0001）。
糖尿病与造影剂诱导的急性肾损伤较高发病率无关。体重指数≥30kg/m²的患者组中造影剂诱导的肾损伤患病率较高，但未达到统计学显著性，需要在更大规模研究中进一步评估。
