Hooda Faisal, Kassam Nadeem, Somji Samina, Makakala Mandela, Noorani Mariam, Bakshi Fatma, Mvungi Robert
Internal Medicine, Aga Khan University Medical College East Africa, Dar es Salaam, TZA.
Pediatric Medicine, Aga Khan University Medical College East Africa, Dar es Salaam, TZA.
Cureus. 2023 Mar 16;15(3):e36219. doi: 10.7759/cureus.36219. eCollection 2023 Mar.
Coronary artery disease (CAD) is the leading cause of mortality and morbidity globally. Percutaneous coronary intervention (PCI) is a minimally-invasive lifesaving intervention for these patients; however, acute kidney injury (AKI) is a serious complication of the procedure commonly occurring due to radiocontrast-induced nephropathy.
A retrospective cross-sectional analytical study was carried out at the Aga Khan Hospital, Dar es Salaam (AKH,D), Tanzania. A total of 227 adults who underwent a percutaneous coronary intervention from August 2014 to December 2020 were enrolled. The AKI was defined based on an increase in absolute and rise in percentage creatinine using the Acute Kidney Injury Network (AKIN), and contrast-induced acute kidney injury (CI-AKI) by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Bivariable and multivariable logistic regression was utilized to analyze factors associated with AKI and the outcomes of these patients.
Twenty-two of the 227 (9.7%) participants sustained AKI. The majority of the study population was male and of Asian ethnicity. No statistically significant factors were associated with AKI. The in-hospital mortality rate was 9% for the AKI versus 2% for non-AKI groups. The AKI group had a longer hospital stay and required ICU care and organ support including hemodialysis.
Nearly 1-in-10 patients undergoing PCI are likely to develop AKI. The in-hospital mortality rate is x4.5 times higher for patients with AKI post-PCI compared to those without AKI. Further larger studies are recommended to determine factors associated with AKI in this population.
冠状动脉疾病(CAD)是全球死亡率和发病率的主要原因。经皮冠状动脉介入治疗(PCI)是针对这些患者的一种微创救生干预措施;然而,急性肾损伤(AKI)是该手术的一种严重并发症,通常由放射造影剂诱发的肾病引起。
在坦桑尼亚达累斯萨拉姆的阿迦汗医院(AKH,D)进行了一项回顾性横断面分析研究。共纳入了2014年8月至2020年12月期间接受经皮冠状动脉介入治疗的227名成年人。根据急性肾损伤网络(AKIN)使用的肌酐绝对值增加和百分比上升来定义AKI,并根据改善全球肾脏病预后组织(KDIGO)的标准定义造影剂诱发的急性肾损伤(CI-AKI)。采用双变量和多变量逻辑回归分析与AKI相关的因素以及这些患者的预后。
227名参与者中有22名(9.7%)发生了AKI。研究人群中大多数为男性且是亚洲族裔。没有与AKI相关的统计学显著因素。AKI组的住院死亡率为9%,而非AKI组为2%。AKI组的住院时间更长,需要重症监护病房护理和包括血液透析在内的器官支持。
近十分之一接受PCI的患者可能会发生AKI。PCI术后发生AKI的患者的住院死亡率比未发生AKI的患者高4.5倍。建议进行进一步的大型研究以确定该人群中与AKI相关的因素。