Cichoń Małgorzata, Wybraniec Maciej T, Okoń Oliwia, Zielonka Marek, Antoniuk Sofija, Szatan Tomasz, Mizia-Stec Katarzyna
First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 40-635 Katowice, Poland.
European Reference Network on Heart Diseases (ERN GUARD-HEART), 1105 AZ Amsterdam, The Netherlands.
J Clin Med. 2023 Mar 10;12(6):2166. doi: 10.3390/jcm12062166.
Contrast-induced acute kidney injury (CI-AKI) can lead to the development of chronic kidney disease (CKD) and impaired in-hospital and long-term outcomes among cardiac patients. The aim of this study was to evaluate the impact of repeated contrast media (CM) administration during a single hospitalization on the rate of CI-AKI. The study group ( = 138) comprised patients with different diagnoses who received CM more than once during hospitalization, while the control group ( = 153) involved CAD patients subject to a single CM dose. Following propensity score matching (PSM), both groups of = 84 were evenly matched in terms of major baseline variables. CI-AKI was defined by an absolute increase in SCr ≥ 0.3 mg/dL or >50% relative to the baseline value within 48-72 h from the last CM dose. Patients in the study group were older, had a higher prevalence of diabetes and CKD, received a higher total volume of CM, had a lower left ventricular ejection fraction, lower prevalence of multivessel coronary artery disease (MV-CAD), and a trend towards a lower prevalence of arterial hypertension and smoking. SCr did not differ between the study and control groups at 72 h after the CM use. CI-AKI occurred in 18 patients in the study (13.0%) and in 18 patients (11.8%) in the control group ( = 0.741). The rate of CI-AKI was also comparable following the PSM (13.1% vs. 13.1%, = 1.0). Logistic regression analysis revealed that CKD, diabetes mellitus, MV-CAD, age, and non-steroidal anti-inflammatory drugs use, but not repeated CM use, were independent predictors of CI-AKI.
对比剂诱导的急性肾损伤（CI-AKI）可导致慢性肾脏病（CKD）的发生，并影响心脏病患者的住院及长期预后。本研究旨在评估单次住院期间重复使用对比剂（CM）对CI-AKI发生率的影响。研究组（n = 138）包括在住院期间接受多次CM的不同诊断患者，而对照组（n = 153）为接受单次CM剂量的CAD患者。经过倾向评分匹配（PSM）后，两组各84例患者在主要基线变量方面均衡匹配。CI-AKI定义为自末次CM剂量起48 - 72小时内血清肌酐（SCr）绝对值升高≥0.3 mg/dL或相对于基线值升高>50%。研究组患者年龄较大，糖尿病和CKD患病率较高，接受的CM总量较高，左心室射血分数较低，多支冠状动脉疾病（MV-CAD）患病率较低，动脉高血压和吸烟患病率呈降低趋势。CM使用后72小时，研究组与对照组的SCr无差异。研究组18例患者（13.0%）发生CI-AKI，对照组18例患者（11.8%）发生CI-AKI（P = 0.741）。PSM后CI-AKI发生率也相当（13.1%对13.1%，P = 1.0）。逻辑回归分析显示，CKD、糖尿病、MV-CAD、年龄和非甾体类抗炎药的使用是CI-AKI的独立预测因素，而重复使用CM不是。
