Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, South China University of Technology, 510080, Guangzhou, China.
Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, 510100, Guangzhou, China.
BMC Nephrol. 2021 Jun 25;22(1):235. doi: 10.1186/s12882-021-02427-6.
Contrast-associated acute kidney injury (CA-AKI) is a common complication with poor prognosis after coronary angiography (CAG). With the prevention methods widely being implemented, the temporal trends of incidence and mortality of CA-AKI are still unknown over the last five years. The study aims to determine the incidence and prognosis of CA-AKI in China.
This retrospective cohort study was based on the registry at Guangdong Provincial People's Hospital in China (ClinicalTrials.gov NCT04407936). We analyzed data from hospitalization patients who underwent CAG and with preoperative and postoperative serum creatinine (Scr) values from January 2013 to December 2017.
11,943 patients were included in the study, in which the mean age was 63.01 ± 10.79 years and 8,469 (71.1 %) were male. The overall incidence of CA-AKI was 11.2 %. Compared with 2013, the incidence of CA-AKI in 2017 was significantly increased from 9.7 to 13.0 % (adjusted odds ratios [aOR], 1.38; 95 %CI, 1.13-1.68; P-value < 0.01, P for trend < 0.01). The temporal trends of incidence among patients of different ages and genders yielded similar findings. During a standardized follow-up of 1 year, 178 (13.7 %) CA-AKI patients died in total, which showed no obvious decreased trend in this 5 five years from 21.1 to 16.5 (adjusted hazard ratio [aHR], 0.72; 95 %CI, 0.36-1.45; P-value = 0.35, P for trend = 0.24).
Our Chinese cohort showed that the incidence of CA-AKI increased significantly, while CA-AKI associated mortality showed no obvious decreased trend in the last five years. Our findings support more active measures to prevent CA-AKI and improve the prognosis of CA-AKI patients.
造影剂相关急性肾损伤（CA-AKI）是冠状动脉造影（CAG）后的常见并发症，预后较差。随着预防措施的广泛实施，过去五年 CA-AKI 的发病率和死亡率的时间趋势仍不清楚。本研究旨在确定中国 CA-AKI 的发病率和预后。
本回顾性队列研究基于中国广东省人民医院的登记处（ClinicalTrials.gov NCT04407936）。我们分析了 2013 年 1 月至 2017 年 12 月期间接受 CAG 并具有术前和术后血清肌酐（Scr）值的住院患者的数据。
共纳入 11943 例患者，平均年龄为 63.01±10.79 岁，8469 例（71.1%）为男性。CA-AKI 的总发生率为 11.2%。与 2013 年相比，2017 年 CA-AKI 的发生率从 9.7%显著增加至 13.0%（调整后的优势比[aOR]，1.38；95%CI，1.13-1.68；P 值<0.01，趋势 P 值<0.01）。不同年龄和性别的患者的发病率趋势也得出了相似的发现。在 1 年的标准化随访期间，共有 178 例（13.7%）CA-AKI 患者死亡，这 5 年期间没有明显的下降趋势，从 21.1%降至 16.5%（调整后的危害比[aHR]，0.72；95%CI，0.36-1.45；P 值=0.35，趋势 P 值=0.24）。
我们的中国队列表明，CA-AKI 的发病率显著增加，而过去五年 CA-AKI 相关死亡率没有明显下降趋势。我们的研究结果支持采取更积极的措施预防 CA-AKI，并改善 CA-AKI 患者的预后。
