Contrast-induced acute kidney injury following coronary angiography: A cohort study of hospitalized patients with or without chronic kidney disease

Authors

Javier A. Neyra
Sunay Shah, Henry Ford Health
Roberta Mooney, Henry Ford Health
Gordon Jacobsen, Henry Ford HealthFollow
Jerry Yee, Henry Ford HealthFollow
James E. Novak, Henry Ford HealthFollow

Recommended Citation

Neyra JA, Shah S, Mooney R, Jacobsen G, Yee J, Novak JE. Contrast-induced acute kidney injury following coronary angiography: A cohort study of hospitalized patients with or without chronic kidney disease. Nephrology Dialysis Transplantation 2013; 28(6):1463-1471.

Document Type

Article

Publication Date

6-1-2013

Publication Title

Nephrology Dialysis Transplantation

Abstract

BackgroundContrast-induced acute kidney injury (CIAKI) has been linked to unfavorable consequences. In routine clinical practice, small increases in serum creatinine (SCr) following coronary angiography tend to be underestimated, especially in patients without chronic kidney disease (CKD).MethodsWe conducted a retrospective observational cohort study to analyze in-hospital and long-term outcomes of CIAKI following coronary angiography in patients with or without CKD (eGFR ≥ 60 mL/min/1.73 m2) from January 2008 through December 2009. CIAKI was defined as SCr either ≥ 25% or ≥ 0.5 mg/dL from baseline within 72 h after contrast exposure. Multivariable logistic regression for in-hospital mortality and Cox proportional hazards calculations for long-term mortality and requirement for dialysis were performed.ResultsA total of 1160 patients were included in the study. CIAKI occurred in 19% of CKD patients and in 18% of non-CKD patients. In CKD and non-CKD patients, CIAKI was more frequent in patients requiring mechanical ventilation or inotropes or in those given furosemide, and it was associated with adverse in-hospital (prolonged hospitalization, acute dialysis and mortality) and long-term (increased creatinine, initiation of dialysis and mortality) outcomes. In multivariable analysis, CKD patients had greater in-hospital mortality if they developed CIAKI (adjusted OR 8, 95% CI 1.9-34.5, P =0.005), and non-CKD patients had greater long-term mortality if they developed CIAKI (adjusted HR 2.2, 95% CI 1.2-4.1, P =0.016).ConclusionsCIAKI following coronary angiography was associated with adverse in-hospital and long-term outcomes in both CKD and non-CKD patients. © 2013 The Authors.

PubMed ID

23585585

Volume

28

Issue

6

First Page

1463

Last Page

1471