Contrast-associated acute kidney injury in patients with arterial hypertension and stable coronary artery disease

Abstract

Relevance.The combination of stable coronary artery disease (CAD) and arterial hypertension (AH) is one of the most common seen by cardiologists. The administration of contrast media might increase the risk of development of acute kidney injury, especially in patients with comorbidities. The influence of iodine contrast media administration on the risk of development of contrast-associated acute kidney injury (CA-AKI) in patients with stable CAD and AH was studied in our work.
 Materials and methods.863 patients with stable CAD and AH and indications for interventions requiring intraarterial administration of contrast media were included in the prospective open observational cohort study (ClinicalTrials.gov ID NCT04014153). CA-AKI was defined according to KDIGO criteria as the elevation of serum creatinine 25% and more above baseline or 0.5 mg/dl (44 mkmol/l) and more in 48 hours after intraarterial administration of contrast media. The primary endpoint was the development of CA-AKI.
 Results.Diabetes mellitus, obesity and hyperuricemia were not statistically significant risk factors of CA-AKI development according to the contingency tables analyses, unlike proteinuria. A logistic regression model was built (area under the curve 0.7638,p0.0001, 95% confidence interval 0.7130.815) and included the following risk factors: age, weight, body mass index, female gender, heart failure, proteinuria, AH, anemia, baseline creatinine. Proteinuria, baseline creatinine and contrast volume were statistically significant ones.
 Conclusion.The rate of CA-AKI was 12.6%. Proteinuria, baseline creatinine and contrast volume were statistically significant risk factors of CA-AKI in logistic regression model.
 Key words:contrast-induced acute kidney injury, contrast-induced nephropathy, contrast-associated acute kidney injury, coronary artery disease, percutaneous coronary intervention, arterial hypertension, stable coronary artery disease, prognosis.