Activities of Daily Living Predict Contrast-Associated Acute Kidney Injury among Population Undergoing Coronary Angiography

Abstract

The Barthel index is a widely used assessment tool for evaluating physical performance in activities of daily living. The present study investigated the relationship between activities of daily living measured by Barthel Index at hospital admission and the occurrence of contrast-associated acute kidney injury among patients undergoing coronary angiography or percutaneous coronary intervention. In this retrospective cross-sectional study, 3148 patients undergoing coronary angiography or percutaneous coronary intervention were enrolled. Activities of daily living were stratified into 5 degrees according to Barthel index scores. Contrast-associated acute kidney injury was defined as an increase of either 25 % or 0.5 mg/dl (44.2 μmol/l) in basal serum creatinine level within 72 h, following the use of contrast agent. Univariable and multivariable linear and logistic regression analysis were used to determine the associations of Barthel index with the proportion of serum creatinine elevation and contrast-associated acute kidney injury, respectively. The exploratory subgroup analysis was further conducted. Totally, 16.7 % of patients suffered from contrast-associated acute kidney injury and the mean age was 67.07±10.71 y old, 65.7 % for males. Multivariable linear regression analysis demonstrated that Barthel index scores were significantly associated with the proportion of serum creatinine elevation (beta=-10.150, 95 % confidence interval=-11.788 to -8.511, p<0.001). Multivariable linear regression analysis demonstrated that Barthel index scores were independent predictors of contrast-associated acute kidney injury incidence (p<0.001). With the increase in Barthel index scores, the incidence of contrast-associated acute kidney injury showed a significant downward tendency. Subgroup analysis showed consistent results. Activities of daily living measured by Barthel index at hospital admission was an independent prediction indicator to assess contrast-associated acute kidney occurrence among patients undergoing coronary angiography or percutaneous coronary intervention.