Abstract
Background Contrast-associated acute kidney injury (CA-AKI) is a major adverse effect of coronary angiography (CAG). Patients with chronic kidney disease (CKD) and coronary artery disease (CAD) are at high risk of CA-AKI. This study aimed to investigate the association between prognostic nutritional index (PNI) and CA-AKI in this high-risk population. Methods This study enrolled a total of 4,391 patients. CA-AKI was defined as a serum creatinine increase ≥0.3 mg/dL or 50% from baseline within the first 48 hours following CAG. The PNI was calculated upon hospital admission: serum albumin (g/L) + 5 × total lymphocyte count (109/L). PNI was analysed from the high level to low level as a continuous variable and categorical variable which was divided into four groups by quartile. Restricted cubic splines and logistic regression were applied. Results Overall, 13.09% (575/4391) of patients developed CA-AKI. PNI score was significantly lower in patients with CA-AKI than that in patients without CA-AKI (P < 0.01). The relationship between PNI score and CA-AKI was linear. A logistic regression model revealed that decreased PNI score was associated with increased risk of CA-AKI [per 1-point decrement; adjusted OR = 1.08, 95% CI, 1.05–1.09; compared with Quartile 1 (PNI ≥ 46.30), Quartile 4 (PNI < 37.90), adjusted OR = 1.88, 95% CI: 1.41–2.51; and Quartile 3 (37.90 ≤ PNI < 42.15), adjusted OR = 1.37, 95% CI: 1.02–1.84]. Conclusion Our study indicated a negative linear relationship between PNI score and CA-AKI in patients undergoing CAG complicated with CKD and CAD. It suggested that malnutrition is associated with increased risk of CA-AKI in this population.
Highlights
Contrast-associated acute kidney injury (CA-AKI) is the third largest cause of hospital-acquired kidney injury which is related to prolonged hospital stay and poor long-term prognosis [1, 2]
It was demonstrated that malnutrition was common in patients with coronary artery disease (CAD) [5], and malnutrition was closely related to the occurrence of acute kidney injury (AKI) in hospitalized patients [6,7,8]. e prognostic nutritional index (PNI) is a screening tool for the nutritional status and has been described as a simple and objective indicator [9]
When PNI was analysed as a continuous variable, lower PNI value was associated with the development of AKI in multivariable regression
Summary
Contrast-associated acute kidney injury (CA-AKI) is the third largest cause of hospital-acquired kidney injury which is related to prolonged hospital stay and poor long-term prognosis [1, 2]. Chronic kidney disease (CKD) is a major risk factor for CA-AKI [3, 4]. It was demonstrated that malnutrition was common in patients with coronary artery disease (CAD) [5], and malnutrition was closely related to the occurrence of acute kidney injury (AKI) in hospitalized patients [6,7,8]. Patients with CKD and CAD were at high risk of CA-AKI. No study investigated the association between PNI and CA-AKI among this population. Contrast-associated acute kidney injury (CA-AKI) is a major adverse effect of coronary angiography (CAG). Patients with chronic kidney disease (CKD) and coronary artery disease (CAD) are at high risk of CA-AKI. Is study aimed to investigate the association between prognostic nutritional index (PNI) and CA-AKI in this high-risk population. PNI score was significantly lower in patients with CA-AKI than that in patients without CA-AKI (P < 0.01)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
