MO169FUNCTIONAL STATE OF THE KIDNEYS IN PATIENT AFTER CORONARY REVASCULARIZATION

Abstract

Abstract Background and Aims The aim of the study was to study the functional state of the kidneys in patients with coronary artery disease in the long-term period after coronary revascularization. Method There were 160 patients with coronary artery disease under observation who underwent re-endovascular procedures (RE). The average age of the patients was 56.6 ± 1.27 years. The study included patients with an eGFR of at least 60 ml / min, determined by the serum creatinine concentration. A dynamic determination of the serum creatinine concentration was carried out to isolate patients in whom the postoperative REB was complicated by contrast-induced nephropathy (CIN). In the present study, CIN was defined as an increase in serum creatinine concentration by 25% 24 or more hours after REB. In the future, all patients underwent dynamic determination of serum creatinine concentration in terms of 3 months - 1 year -2 years. Patients received standard therapy for coronary artery disease: antiplatelet therapy (in the case of stenting of coronary arteries - double therapy), bisoprolol, valsartan, atorvastatin. Results The results of the study showed that during 2 years of follow-up after coronary revascularization, a progressive decrease in eGFR was observed. So, by the 3rd month, eGFR decreased by -17.39 ± 1.17%, by the end of the 1st year - by -43.62 ± 1.28%, by the end of the second year of observation - by -46.50 ± 1.79%. At the same time, the decrease in eGFR was significantly more pronounced in the group of patients who had CIN in the early period after endovascular intervention (37 patients): (-39.82 ± 2.02% by the end of the 3rd month, -54.61 ± 2.94% by the end of the 1st year and -60.10 ± 3.99% by the end of the 2nd year of observation versus -10.65 ± 0.57%, -40.32 ± 1, 27% and -42.41 ± 1.85% in patients with CIN-, respectively, p <0.001 for intergroup comparisons of the relative dynamics of eGFR at all three time points). Conclusion Thus, the present study has demonstrated that in patients with coronary artery disease after revascularization, there is a significant decrease in the glomerular filtration function of the kidneys as early as 3 months after the endovascular procedure. CKD progression continues for at least 2 years after revascularization. One of the predictors of CKD progression is the development of CIN in the early period after endovascular intervention.