Association Between Non-Recovered Contrast-Associated Acute Kidney Injury and Poor Prognosis in Patients Undergoing Coronary Angiography

Frontiers in Cardiovascular Medicine

article

Dianhua Zhou¹  Zhubin Lun¹  Bo Wang²  Jin Liu²  Liwei Liu²  Guanzhong Chen²  Ming Ying²  Huanqiang Li²  Shiqun Chen²  Ning Tan²  Jiyan Chen²  Yong Liu²  Jianfeng Ye¹ 

[1] Department of Cardiology, Dongguan TCM Hospital;Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences;The First School of Clinical Medicine, Guangdong Medical University;Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University

关键词: recovered;    non-recovered;    contrast-associated acute kidney injury;    coronary angiography;    all-cause mortality;   

DOI  :  10.3389/fcvm.2022.823829

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background Previous studies have shown that renal function recovery after acute kidney injury (AKI) was associated with decreased risk of all-cause mortality. However, little is known about the correlation between renal function recovery and long-term prognosis in patients with contrast-associated acute kidney injury (CA-AKI) undergoing coronary angiography (CAG). Methods We retrospectively enrolled 5,865 patients who underwent CAG. CA-AKI was defined as an increase in serum creatinine (SCr) ≥ 50% or ≥ 0.3 mg/dl from baseline within 72 h post procedure. Recovered CA-AKI was defined as a decrease in SCr to baseline or no CA-AKI level. The first endpoint was long-term all-cause mortality. Kaplan–Meier analysis and Cox regression analysis were used to investigate the association between kidney function recovery and long-term mortality. Results During the median follow-up period of 5.25 years, the overall long-term mortality was 20.07%, and the long-term mortality in patients with recovered CA-AKI and non-recovered CA-AKI was 17.46 and 27.44%, respectively. After multivariate Cox hazard regression, non-recovered CA-AKI was significantly associated with long-term mortality, while recovered CA-AKI was not [recovered CA-AKI vs. no CA-AKI, hazard ratio (HR) = 1.06, 95% confidence interval (CI): 0.81–1.39, p = 0.661; non-recovered CA-AKI vs. no CA-AKI, HR = 1.39, 95% CI: 1.21–1.60, p < 0.001]. In the subgroup of CAD, both recovered CA-AKI and non-recovered CA-AKI were associated with increased risk of long-term all-cause mortality. However, in other subgroup analyses, only non-recovered CA-AKI was associated with increased risk of long-term all-cause mortality. Conclusion Our results found that non-recovered CA-AKI is significantly associated with long-term mortality. In patients with CAD, recovered CA-AKI can still increase the risk of all-cause mortality. Clinicians need to pay more attention to patients suffering from CA-AKI, whose kidney function has not recovered. In addition, active prevention treatments should be taken by patients with CAD.

【 授权许可】

CC BY