Long-term renal outcomes after elective percutaneous coronary intervention in patients with advanced renal dysfunction.

Abstract

The aim of the present study was to evaluate the renal outcomes, including the time course of renal function, after elective PCI in patients with advanced renal dysfunction and to assess the predictors of renal dysfunction progression. This is a subanalysis of a previous observational multicenter study that investigated long-term clinical outcomes in patients with advanced renal dysfunction (eGFR < 30mL/min/1.73 m2), focusing on 151 patients who underwent elective PCI and their long-term renal outcomes. Renal dysfunction progression was defined as a 20% relative decrease in eGFR at 1year from baseline or the initiation of permanent dialysis within 1year. Progression of renal dysfunction at 1year occurred in 42 patients (34.1%). Among patients with renal dysfunction progression, the decrease of renal function from baseline was not observed at 1month but after 6months of the index PCI. Baseline eGFR and serum albumin level were significant predictors of renal dysfunction progression at 1year. Among 111 patients who had not been initiated on dialysis within 1year, those with renal dysfunction progression had a significantly higher incidence of dialysis initiation more than 1year after the index PCI than those with preserved renal function (p < 0.001). Among patients with advanced renal dysfunction who underwent elective PCI, 34.1% showed renal dysfunction progression at 1year. The decrease in renal function was not observed at 1month but after 6months of the index PCI in patients with renal dysfunction progression. Furthermore, patients with renal dysfunction progression had poorer long-term renal outcomes.