Abstract
ObjectiveThe present study investigated the predictive value of albuminuria for contrast-induced nephropathy (CIN) non-recovery in patients undergoing percutaneous coronary intervention (PCI).MethodsWe retrospectively enrolled 550 consecutive patients inflicted with CIN after PCI and reassessing kidney function among 1 week–12 months between January 2012 and December 2018. Patients were stratified into three groups according to urine albumin: negative group (urine dipstick negative), trace group (urine dipstick trace) and positive group (urine dipstick ≥ 1 +). The primary outcomes were CIN non-recovery (a decrease of serum creatinine which remains ≥ 25% or 0.5 mg/dL over baseline at 1 week–12 months after PCI in patients inflicted with CIN). The odds ratio (OR) of CIN non-recovery was analyzed by logistic regression using the negative urine dipstick group as the reference group.ResultsOverall, 88 (16.0%) patients had trace urinary albumin, 74 (13.5%) patients had positive urinary albumin and 40 (7.3%) patients developed CIN non-recovery. Patients with positive urinary albumin had significantly higher incidence of CIN non-recovery [negative (3.4%), trace (11.4%) and positive (23.0%), respectively; P < 0.0001]. Multivariate analysis showed that trace and positive urinary albumin were associated with an increased risk of CIN non-recovery (trace vs negative: OR 2.88, P = 0.022; positive vs negative: OR 2.99, P = 0.021). These associations were consistent in subgroups of patients stratified by CIN non-recovery risk predictors. And CIN non-recovery was associated with an increased risk of long-term mortality during a mean follow-up period of 703 days (P < 0.001).ConclusionPreprocedural albuminuria was associated with CIN non-recovery in patients undergoing PCI.
Highlights
Contrast-induced nephropathy (CIN), a common complication after coronary intervention procedure, has proved to be associated with poor short- and long-term outcomes [1]
Hypotension was defined as systolic blood pressure (SBP) < 80 mmHg for at least 1 h requiring the support with medications or intra-aortic balloon pump (IABP) within 24 h peri-procedure [8]
Baseline characteristics positive urinary albumin remained associated with increased risk of CIN non-recovery, the odds ratio (OR) values were 2.88 and 2.99, respectively
Summary
Contrast-induced nephropathy (CIN), a common complication after coronary intervention procedure, has proved to be associated with poor short- and long-term outcomes [1]. On. International Urology and Nephrology one hand, most of it was temporary strike meaning limited effects on prognosis. When physicians identify the true high-risk patients who are susceptible to poor outcomes, they could take timely, economical and effective measures. The prognosis is determined on the severity of CIN and the progression of renal recovery which was highlighted by several studies that indicated a very close association with the major adverse cardiovascular and nephropathic events. We should remain vigilant at the renal function for a long postoperative period, identify the high-risk patients who are likely to develop CIN non-recovery and take necessary measures in time
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