Microalbuminuria Complicated with Low Estimated Glomerular Filtration Rate: Early Risk Factors for Contrast-Induced Acute Kidney Injury After Coronary Intervention.

Abstract

BackgroundWe aimed to investigate the impact of microalbuminuria complicated with low estimate glomerular filtration rate (eGFR) on the incidence and prognosis of contrast-induced acute kidney injury (CI-AKI) in patients with coronary artery disease after coronary intervention.Material/MethodsA total of 943 patients were enrolled in the study. Based on microalbumin/creatinine (ACR) measurements, the patients were divided into a microalbuminuria cohort (MA; 222 patients) and a normal albuminuria cohort (NA; 721 patients). According to eGFR levels, the cohorts were further subdivided into normal, mild, moderate, and severe renal dysfunction groups. The basic data and indicators of all enrolled patients were collected. The patients were followed up at 30 days, 6 months, 1 year, and 3 years after surgery.ResultsThe overall incidence of CI-AKI in the MA cohort was higher than that in the NA cohort (17.6% vs 8.2%, P<0.001). The incidence of CI-AKI in different eGFR groups in the MA cohort was significantly different among the normal renal function group (3.3%), mild renal dysfunction group (9.2%), moderate renal dysfunction group (24.6%), and severe renal dysfunction group (36%) (P<0.001). When microalbuminuria was complicated with eGFR <45 mL/min/1.73 m2, the risk of CI-AKI increased (P<0.001). During the 3-year follow-up, the rehospitalization rate and incidence of major adverse cardiovascular events in patients with low eGFR levels complicated with microalbuminuria were significantly higher than those with normal albuminuria (42.8% vs 19.9%, 16.3% vs 3.5%, P<0.001).ConclusionsMicroalbuminuria complicated with low eGFR levels may increase the risk of CI-AKI and adverse cardiovascular events in patients after coronary intervention.