Acute kidney injury following coronary angiography : a nationwide study of incidence, risk factors and long-term outcomes
(2018) In Journal of Nephrology 31(5). p.721-730- Abstract
BACKGROUND: We studied the incidence and risk factors of acute kidney injury (AKI) following coronary angiography (CA) and examined short- and long-term outcomes of patients who developed AKI, including progression of chronic kidney disease (CKD).
METHODS: This was a retrospective study of all patients undergoing CA in Iceland from 2008 to 2015, with or without percutaneous coronary intervention. All procedures were performed with iso-osmolar contrast. AKI was defined according to the SCr component of the KDIGO criteria. Patients without post-procedural SCr were assumed to be free of AKI. Incident CKD was defined as 90-day sustained estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, and progression of CKD as... (More)
BACKGROUND: We studied the incidence and risk factors of acute kidney injury (AKI) following coronary angiography (CA) and examined short- and long-term outcomes of patients who developed AKI, including progression of chronic kidney disease (CKD).
METHODS: This was a retrospective study of all patients undergoing CA in Iceland from 2008 to 2015, with or without percutaneous coronary intervention. All procedures were performed with iso-osmolar contrast. AKI was defined according to the SCr component of the KDIGO criteria. Patients without post-procedural SCr were assumed to be free of AKI. Incident CKD was defined as 90-day sustained estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, and progression of CKD as worsening at least one stage sustained over 90 days.
RESULTS: AKI was detected in 231 of 13,561 cases (1.7%). There was an interaction between contrast dose and preexisting kidney function, where the risk for AKI was only significant at a dose > 150 mL in patients with baseline eGFR < 45 mL/min/1.73 m2 (OR 5.3, 95% CI 2.1-14.2). The AKI patients had worse short-and long-term survival, as well as elevated hazard of both new-onset CKD (HR 3.7, 95% CI 2.7-5.0) and progression of preexisting CKD (HR 2.0, 95% CI 1.5-2.6) over a median follow-up of 3.3 years (range 0.1-8.4 years), compared to a propensity score-matched control group.
CONCLUSIONS: For iso-osmolar contrast, the risk of AKI related to contrast dose was evident for higher amount of contrast in patients with baseline eGFR < 45 mL/min/1.73 m2. In addition to association with adverse short- and long-term survival AKI had a strong association with new-onset or progression of CKD when patients were followed longitudinally.
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- author
- Helgason, Dadi LU ; Long, Thorir E LU ; Helgadottir, Solveig ; Palsson, Runolfur ; Sigurdsson, Gisli H ; Gudbjartsson, Tomas ; Indridason, Olafur S ; Gudmundsdottir, Ingibjorg J and Sigurdsson, Martin I
- publishing date
- 2018-10
- type
- Contribution to journal
- publication status
- published
- keywords
- Acute Kidney Injury/chemically induced, Aged, Aged, 80 and over, Contrast Media/adverse effects, Coronary Angiography/adverse effects, Disease Progression, Dose-Response Relationship, Drug, Female, Glomerular Filtration Rate/drug effects, Humans, Iceland/epidemiology, Incidence, Kidney/drug effects, Male, Middle Aged, Prognosis, Renal Insufficiency, Chronic/diagnosis, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors
- in
- Journal of Nephrology
- volume
- 31
- issue
- 5
- pages
- 721 - 730
- publisher
- Springer
- external identifiers
-
- scopus:85052934739
- pmid:30187381
- ISSN
- 1724-6059
- DOI
- 10.1007/s40620-018-0534-y
- language
- English
- LU publication?
- no
- id
- 55e05a65-08d3-40ae-b2cc-f897c39e9184
- date added to LUP
- 2024-12-05 16:12:43
- date last changed
- 2025-01-03 05:58:28
@article{55e05a65-08d3-40ae-b2cc-f897c39e9184,
abstract = {{<p>BACKGROUND: We studied the incidence and risk factors of acute kidney injury (AKI) following coronary angiography (CA) and examined short- and long-term outcomes of patients who developed AKI, including progression of chronic kidney disease (CKD).</p><p>METHODS: This was a retrospective study of all patients undergoing CA in Iceland from 2008 to 2015, with or without percutaneous coronary intervention. All procedures were performed with iso-osmolar contrast. AKI was defined according to the SCr component of the KDIGO criteria. Patients without post-procedural SCr were assumed to be free of AKI. Incident CKD was defined as 90-day sustained estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, and progression of CKD as worsening at least one stage sustained over 90 days.</p><p>RESULTS: AKI was detected in 231 of 13,561 cases (1.7%). There was an interaction between contrast dose and preexisting kidney function, where the risk for AKI was only significant at a dose > 150 mL in patients with baseline eGFR < 45 mL/min/1.73 m2 (OR 5.3, 95% CI 2.1-14.2). The AKI patients had worse short-and long-term survival, as well as elevated hazard of both new-onset CKD (HR 3.7, 95% CI 2.7-5.0) and progression of preexisting CKD (HR 2.0, 95% CI 1.5-2.6) over a median follow-up of 3.3 years (range 0.1-8.4 years), compared to a propensity score-matched control group.</p><p>CONCLUSIONS: For iso-osmolar contrast, the risk of AKI related to contrast dose was evident for higher amount of contrast in patients with baseline eGFR < 45 mL/min/1.73 m2. In addition to association with adverse short- and long-term survival AKI had a strong association with new-onset or progression of CKD when patients were followed longitudinally.</p>}},
author = {{Helgason, Dadi and Long, Thorir E and Helgadottir, Solveig and Palsson, Runolfur and Sigurdsson, Gisli H and Gudbjartsson, Tomas and Indridason, Olafur S and Gudmundsdottir, Ingibjorg J and Sigurdsson, Martin I}},
issn = {{1724-6059}},
keywords = {{Acute Kidney Injury/chemically induced; Aged; Aged, 80 and over; Contrast Media/adverse effects; Coronary Angiography/adverse effects; Disease Progression; Dose-Response Relationship, Drug; Female; Glomerular Filtration Rate/drug effects; Humans; Iceland/epidemiology; Incidence; Kidney/drug effects; Male; Middle Aged; Prognosis; Renal Insufficiency, Chronic/diagnosis; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors}},
language = {{eng}},
number = {{5}},
pages = {{721--730}},
publisher = {{Springer}},
series = {{Journal of Nephrology}},
title = {{Acute kidney injury following coronary angiography : a nationwide study of incidence, risk factors and long-term outcomes}},
url = {{http://dx.doi.org/10.1007/s40620-018-0534-y}},
doi = {{10.1007/s40620-018-0534-y}},
volume = {{31}},
year = {{2018}},
}