Radiocontrast-Induced Acute Kidney Injury Following Coronary Angiography and Percutaneous Coronary Intervention: A Retrospective Cohort Study
American Journal of Internal Medicine
Volume 6, Issue 5, September 2018, Pages: 138-143
Received: Aug. 22, 2018;
Accepted: Sep. 10, 2018;
Published: Oct. 10, 2018
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Van Bui Pham, Department of Nephrology-Urology-Transplantation, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
Quang Dung Nguyen, Department of Cardiology and Cardiovascular Intervention, Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam
Nghia Huynh Thi Nguyen, Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
Thanh Phuong Pham Nguyen, Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
Thanh Liem Vo, Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
Minh Cuong Duong, School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia
Despite the remarkable technological advances in coronary angiography (CA)/percutaneous coronary intervention (PCI) for diagnosis and treatment of coronary artery disease, the contrast-induced acute kidney injury (CI-AKI) is always an important cause of hospital-acquired AKI. Most local CI-AKI studies in Vietnam had small sample sizes and short-term follow-up of only 24-48 hours following CA or PCI intervention, resulting in controversial conclusions. We conducted a study of the incidence of CI-AKI during a longer follow-up time period and associated risk factors among adult patients undergoing CA/ PCI at Nguyen Tri Phuong University Public Hospital and Tam Duc Private Cardiology Center in Ho Chi Minh City, Vietnam between January 2014 and March 2015. All 320 patients with CA/PCI at the two hospitals were enrolled in a retrospective cohort study. Information on demographic data, treatment, and laboratory test results was collected from the patients’ records. The total cumulative incidence of CI-AKI at 24, 48, 72 and ≥72 hours following CA/PCI was 6.7%, 12%, 14% and 16.9% respectively. Prognostic factors for CI-AKI included an increase by 1 ml/min/1,73m² in clearance creatinine before the intervention (P = 0.006, Hazard Ratio (HR) = 0.970, 95%CI 0.949 – 0.991) and an increase by 1% in ejection fraction (P = 0.023, HR = 0.984, 95%CI 0.970 – 0.998). Delayed CI-AKI was not rare after CA/PCI intervention. Therefore, it is pivotal to monitor serum creatinine in a longer time after the intervention to timely detect CI-AKI. Also, information on risk factors such as emergency interventions, chronic kidney disease, and ejection fraction < 45% could assist in predicting CI-AKI development.
Van Bui Pham,
Quang Dung Nguyen,
Nghia Huynh Thi Nguyen,
Thanh Phuong Pham Nguyen,
Thanh Liem Vo,
Minh Cuong Duong,
Radiocontrast-Induced Acute Kidney Injury Following Coronary Angiography and Percutaneous Coronary Intervention: A Retrospective Cohort Study, American Journal of Internal Medicine.
Vol. 6, No. 5,
2018, pp. 138-143.
Kizilbbash Mohammad, Parker Jeffrey R., Sarwar Muhammad A., et al. Ischemic Heart Disease. In: The washington manual medical therapeutics. 34 ed: Lippincott Williams & Wilkins; 2014:112-70.
Seeliger E., Sendeski M., Rihal C. S., et al. Contrast-induced kidney injury: mechanisms, risk factors, and prevention. European heart journal. ;33:2007-15.
Finn W. F. The clinical and renal consequences of contrast-induced nephropathy. Nephrol Dial Transplant. ;21:i2-10.
Rear R., Bell R. M., Hausenloy D. J. Contrast-induced nephropathy following angiography and cardiac interventions. Heart. ;102:638-48.
Rudnick MR. Pathogenesis, clinical features, and diagnosis of contrast-induced nephropathy. In: Palevsky PM, Sheridan AM, eds. UpToDate. Alphen aan den Rijn, Netherlands: UpToDate; 2017.
Maioli M., Toso A., Leoncini M., et al. Persistent renal damage after contrast-induced acute kidney injury: incidence, evolution, risk factors, and prognosis. Circulation. ;125:3099-107.
Solomon R. Contrast-induced acute kidney injury: is there a risk after intravenous contrast? Clinical journal of the American Society of Nephrology : CJASN. ;3:1242-3.
Aubry P., Brillet G., Catella L., et al. Outcomes, risk factors and health burden of contrast-induced acute kidney injury: an observational study of one million hospitalizations with image-guided cardiovascular procedures. BMC nephrology. ;17:167.
Xu J., Zhang M., Ni Y., et al. Impact of low hemoglobin on the development of contrast-induced nephropathy: A retrospective cohort study. Experimental and therapeutic medicine. ;12:603-10.
Disease Kidney. Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney inter., Suppl. ;2:1-138.
Mehran R., Aymong E. D., Nikolsky E., et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. Journal of the American College of Cardiology. ;44:1393-9.
Li W. H., Li D. Y., Han F., et al. Impact of anemia on contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary interventions. International urology and nephrology. ;45:1065-70.
Suc Khoe & Doi Song. Vietnam has more than 50 coronary interventional centers [in Vietnamese]. 2015; http://www.yhth.vn/viet-nam-da-co-tren-50-don-vi-tim-mach-can-thiep_d3338.aspx. Accessed 2 May, 2018.
Weaver MA. Sample Size Calculations for Survival Analysis. 2009; http://www.icssc.org/Documents/AdvBiosGoa/Tab%2026.00_SurvSS.pdf. Accessed 2 April, 2017.
Ozkok S., Ozkok A. Contrast-induced acute kidney injury: A review of practical points. World journal of nephrology. ;6:86-99.
McCullough P. A. Contrast-induced acute kidney injury. Journal of the American College of Cardiology. ;51:1419-28.
Bui Van Pham. Manual of the Diagnosis and the Treatment of Common Diseases in Internal Medicine [in Vietnamese]. In: Chronic Kidney Disease. Vietnam: Medicine Publishing; 2008:97-128.
DW Cockcroft, MH Gault. Prediction of creatinine clearance from serum creatinine. . Nephron. ;16:31-41.
Cigarroa R. G., Lange R. A., Williams R. H., et al. Dosing of contrast material to prevent contrast nephropathy in patients with renal disease. Am J Med. ;86:649-52.
Bouzas-Mosquera Alberto. Contrast-induced nephropathy and acute renal failure following urgent cardiac catheterization: incidence, risk factor, and prognosis. Revista espanola de cardiologia. ;60:1026-34.
Neyra J. A., Shah S., Mooney R., et al. Contrast-induced acute kidney injury following coronary angiography: a cohort study of hospitalized patients with or without chronic kidney disease. Nephrol Dial Transplant. ;28:1463-71.
Wi J., Ko Y. G., Kim J. S., et al. Impact of contrast-induced acute kidney injury with transient or persistent renal dysfunction on long-term outcomes of patients with acute myocardial infarction undergoing percutaneous coronary intervention. Heart. ;97:1753-7.
Basu A. Contrast-induced nephropathy. 2017; https://emedicine.medscape.com/article/246751-overview. Accessed 11 March, 2018.
Minh Thien Doan Nguyen, Nhan Thanh Vo. Serum cystatin in diagnosis of contrast-induced nephropathy early after percutaneos coronary intervention [in Vietnamese]. Ho Chi Minh City Journal of Medicine. 2010;14(2):93-100.
Nguyen DC, Ho TD, Chau VV. The effect of contrast medium on renal function in patients with coronary intervention [in Vietnamese]. Ho Chi Minh City Journal of Medicine. 2012;16(1):83-87.
Giacoppo et al. Impact of Contrast-Induced Acute Kidney Injury After Percutaneous Coronary Intervention on Short- and Long-Term Outcomes: Pooled Analysis From the HORIZONS-AMI and ACUITY Trials. Circulation Cardiovascular interventions. 2015;8:e002475.
Caspi O., Habib M., Cohen Y., et al. Acute Kidney Injury After Primary Angioplasty: Is Contrast-Induced Nephropathy the Culprit? Journal of the American Heart Association. ;6.
Yancy C. W., Jessup M., Bozkurt B., et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. ;62:e147-239.
Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European heart journal. 2014;35(37):2541-2619.