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Strategies may be needed to reduce acute kidney injury in PCI
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Acute kidney injury was reported in approximately 7% of patients who underwent PCI, according to results of a large retrospective analysis.
The investigators reviewed National Cardiovascular Data Registry data from June 2009 to June 2011 to determine contemporary incidence, predictors and outcomes of acute kidney injury associated with PCI. They aimed to identify risk factors for this complication in a cohort of 985,737 consecutive patients who underwent interventions at 1,253 sites.
Changes reported for in-hospital serum creatinine level according to the Acute Kidney Injury Network criteria served as the primary outcome measure.
Acute kidney injury was reported in 7.1% of the cohort. New dialysis was necessary in 0.3% of those patients.
Multivariate analysis results indicated that STEMI at presentation (OR=2.60; 95% CI, 2.53-2.67), severe chronic kidney disease (OR=3.59; 95% CI, 3.47-3.71) and cardiogenic shock (OR=2.92; 95% CI, 2.80-3.04) were strongly associated with acute kidney injury development.
Patients with acute kidney injury experienced an in-hospital mortality rate of 9.7%. By comparison, the in-hospital mortality rate was 34% for individuals requiring dialysis and 0.5% for those without acute kidney injury (P<.001).
Acute kidney injury (OR=7.8; 95% CI, 7.4-8.1) and dialysis (OR=21.7; 95% CI, 19.6-24.1) continued to independently predict in-hospital mortality in the adjusted multivariate analysis.
“Defining strategies to minimize the risk of [acute kidney injury] in patients undergoing PCI are needed to improve the safety and outcomes of the procedure,” the investigators concluded.
Disclosure: The researchers report financial disclosures with companies including Amorcyte, AstraZeneca, Eli Lilly, EvaHeart, Genentech, Gilead Sciences, Glumetrics, Medtronic Minimed, Roche and Sanofi-Aventis. See the study for a full list of disclosures.
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