Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
Int Urol Nephrol. 2022 Feb;54(2):429-435. doi: 10.1007/s11255-021-02915-6. Epub 2021 Jun 25.
Malnutrition is a common comorbidity of coronary artery disease (CAD) and is often associated with adverse events. The malnutrition often means lower cholesterol, albumin and high lymphocyte, as risk factors of Contrast-Induced Acute Kidney Injury (CI-AKI). We aim to evaluate the association between malnutrition and CI-AKI following coronary angiography (CAG) in CAD patients.
We analyzed 3170 CAD patients with variables of nutritional status (Controlling Nutritional Status score (CONUT)) from the prospective multicenter study, REICIN (NCT01402232) including 4,271 consecutive patients undergoing CAG from January 2013 to February 2016. Patients were divided into the normal group (CONUT score 0-1) and malnutrition group (CONUT score > 1). The association of malnutrition and the risk of CI-AKI was examined in all CAD patients using multivariable logistics regression analysis.
Among the 3170 patients (mean age: 63.1 ± 10.7 years), 1865 (58.8%) suffered from malnutrition, 111 (3.5%) developed CI-AKI, including 23 (1.76%) in normal group and 88 (4.72%) in malnutrition group (p < 0.01). The malnourished patients were older, and likely had anemia and worse cardiorenal function. After adjustment for confounders, the risk of CI-AKI was 1.04 times higher in the malnutrition group than in the normal group (adjusted OR: 2.04, 95% CI 1.28-3.38, p < 0.01).
Among CAD patients undergoing CAG, malnutrition is extremely common and associated with a double risk of CI-AKI. Further studies are needed to investigate the potential renal protection of intervening malnutrition in CAD patients.
营养不良是冠状动脉疾病（CAD）的常见合并症，常与不良事件相关。营养不良通常意味着胆固醇、白蛋白降低和淋巴细胞升高，是对比剂诱导急性肾损伤（CI-AKI）的危险因素。我们旨在评估 CAD 患者冠状动脉造影（CAG）后营养不良与 CI-AKI 之间的关系。
我们分析了前瞻性多中心研究 REICIN（NCT01402232）中的 3170 例 CAD 患者的营养状况变量（CONUT 评分），该研究纳入了 2013 年 1 月至 2016 年 2 月期间连续 4271 例行 CAG 的患者。患者分为正常组（CONUT 评分 0-1）和营养不良组（CONUT 评分＞1）。使用多变量逻辑回归分析在所有 CAD 患者中检查营养不良与 CI-AKI 风险的关系。
在 3170 例患者中（平均年龄：63.1±10.7 岁），1865 例（58.8%）患有营养不良，111 例（3.5%）发生 CI-AKI，其中正常组 23 例（1.76%），营养不良组 88 例（4.72%）（p＜0.01）。营养不良患者年龄较大，且可能患有贫血和更差的心肾功能。调整混杂因素后，营养不良组发生 CI-AKI 的风险比正常组高 1.04 倍（调整 OR：2.04，95%CI 1.28-3.38，p＜0.01）。
在接受 CAG 的 CAD 患者中，营养不良极为常见，并与 CI-AKI 的双重风险相关。需要进一步研究以探讨干预 CAD 患者营养不良的潜在肾脏保护作用。
