Oweis Ashraf O, Alshelleh Sameeha A, Saadeh Nesreen, Jarrah Mohamad I, Ibdah Rasheed, Alzoubi Karem H
Division of Nephrology, Department of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan.
Int J Vasc Med. 2020 Dec 21;2020:8864056. doi: 10.1155/2020/8864056. eCollection 2020.
Contrast-induced acute kidney injury (CI-AKI) is a worldwide known complication related to the use of contrast media with either imaging or angiography; it carries its own complications and effect on both morbidity and mortality; early identification of patients at risk and addressing modifiable risk factors may help reducing risk for this disease and its complications.
This was a prospective observational study, where all patients admitted for cardiac catheterization between June 2015 and January 2016 were evaluated for CI-AKI. There were two study groups: contrast-induced acute kidney injury (CI-AKI) group, and noncontrast-induced acute kidney injury (non-CI-AKI) group.
Patients ( = 202) were included and followed up for 4 years. Death and development of chronic kidney disease (CKD) need for another revascularization were the end points. The incidence of CI-AKI was 14.8%.In univariate analysis, age ( = 0.016) and serum albumin at admission ( = 0.001) were statistically significant predictors of overall death. Age ( = 0.002), HTN ( = 0.002), DM ( = 0.02), and the use of diuretics ( = 0.001) had a statistically significant impact on eGFR. The rate of recatheterization was not statistically significant between the two groups (61 (35.5%) for the non-CI-AKI vs. 12 (40%) for the other group; = 0.63). Some inflammatory markers (NGAL = 0.06, IL-19 = 0.08) and serum albumin at admission = 0.07 had a trend toward a statistically significant impact on recatheterization. Death ( = 0.66) and need for recatheterization ( = 0.63) were not statistically different between the 2 groups, while the rate of eGFR decline in for the CI-AKI was significant ( = 0.004).
CI-AKI is a common complication post percutaneous catheterization (PCI), which may increase the risk for CKD, but not death or the need for recatheterization. Preventive measures must be taken early to decrease the morbidity.
造影剂诱导的急性肾损伤（CI-AKI）是一种全球公认的与影像检查或血管造影中使用造影剂相关的并发症；它有其自身的并发症，并对发病率和死亡率产生影响；早期识别高危患者并处理可改变的危险因素可能有助于降低该疾病及其并发症的风险。
这是一项前瞻性观察性研究，对2015年6月至2016年1月期间因心脏导管插入术入院的所有患者进行CI-AKI评估。有两个研究组：造影剂诱导的急性肾损伤（CI-AKI）组和非造影剂诱导的急性肾损伤（非CI-AKI）组。
纳入患者（n = 202）并随访4年。终点为死亡、慢性肾脏病（CKD）进展以及再次血管重建的需求。CI-AKI的发生率为14.8%。在单因素分析中，年龄（P = 0.016）和入院时血清白蛋白（P = 0.001）是总体死亡的统计学显著预测因素。年龄（P = 0.002）、高血压（P = 0.002）、糖尿病（P = 0.02）和利尿剂的使用（P = 0.001）对估算肾小球滤过率（eGFR）有统计学显著影响。两组之间再次导管插入率无统计学差异（非CI-AKI组为61例（35.5%），另一组为12例（40%）；P = 0.63）。一些炎症标志物（中性粒细胞明胶酶相关脂质运载蛋白（NGAL）P = 0.06，白细胞介素-19（IL-19）P = 0.08）和入院时血清白蛋白P = 0.07对再次导管插入有统计学显著影响的趋势。两组之间死亡（P = 0.66）和再次导管插入需求（P = 0.63）无统计学差异，而CI-AKI组的eGFR下降率显著（P = 0.004）。
CI-AKI是经皮导管介入治疗（PCI）后常见的并发症，可能增加CKD风险，但不增加死亡或再次导管插入需求。必须尽早采取预防措施以降低发病率。
