Department of Cardiology, Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
Department of Geriatric Medicine, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China.
Int Urol Nephrol. 2021 Dec;53(12):2603-2610. doi: 10.1007/s11255-021-02818-6. Epub 2021 Mar 6.
The present study investigated the predictive value of albuminuria for contrast-induced nephropathy (CIN) non-recovery in patients undergoing percutaneous coronary intervention (PCI).
We retrospectively enrolled 550 consecutive patients inflicted with CIN after PCI and reassessing kidney function among 1 week-12 months between January 2012 and December 2018. Patients were stratified into three groups according to urine albumin: negative group (urine dipstick negative), trace group (urine dipstick trace) and positive group (urine dipstick ≥ 1 +). The primary outcomes were CIN non-recovery (a decrease of serum creatinine which remains ≥ 25% or 0.5 mg/dL over baseline at 1 week-12 months after PCI in patients inflicted with CIN). The odds ratio (OR) of CIN non-recovery was analyzed by logistic regression using the negative urine dipstick group as the reference group.
Overall, 88 (16.0%) patients had trace urinary albumin, 74 (13.5%) patients had positive urinary albumin and 40 (7.3%) patients developed CIN non-recovery. Patients with positive urinary albumin had significantly higher incidence of CIN non-recovery [negative (3.4%), trace (11.4%) and positive (23.0%), respectively; P < 0.0001]. Multivariate analysis showed that trace and positive urinary albumin were associated with an increased risk of CIN non-recovery (trace vs negative: OR 2.88, P = 0.022; positive vs negative: OR 2.99, P = 0.021). These associations were consistent in subgroups of patients stratified by CIN non-recovery risk predictors. And CIN non-recovery was associated with an increased risk of long-term mortality during a mean follow-up period of 703 days (P < 0.001).
Preprocedural albuminuria was associated with CIN non-recovery in patients undergoing PCI.
本研究旨在探讨尿白蛋白对经皮冠状动脉介入治疗（PCI）后对比剂诱导肾病（CIN）未恢复的预测价值。
我们回顾性纳入了 2012 年 1 月至 2018 年 12 月期间 550 例因 PCI 后发生 CIN 而接受肾功能再评估的连续患者。根据尿白蛋白将患者分为三组：阴性组（尿干化学阴性）、微量组（尿干化学微量）和阳性组（尿干化学≥1+）。主要终点为 CIN 未恢复（发生 CIN 的患者在 PCI 后 1 周-12 个月内，血清肌酐较基线下降≥25%或 0.5mg/dL）。以尿干化学阴性组为参考组，采用 logistic 回归分析 CIN 未恢复的比值比（OR）。
共有 88（16.0%）例患者微量白蛋白尿，74（13.5%）例患者尿白蛋白阳性，40（7.3%）例患者发生 CIN 未恢复。尿白蛋白阳性患者的 CIN 未恢复发生率显著更高[阴性（3.4%）、微量（11.4%）和阳性（23.0%）；P<0.0001]。多变量分析显示，微量和阳性尿白蛋白与 CIN 未恢复的风险增加相关（微量与阴性比较：OR 2.88，P=0.022；阳性与阴性比较：OR 2.99，P=0.021）。这些关联在按 CIN 未恢复风险预测因素分层的患者亚组中一致。CIN 未恢复与长期死亡率增加相关，在平均 703 天的随访期间（P<0.001）。
PCI 前白蛋白尿与 CIN 未恢复有关。
