Contrast-Associated Acute Kidney Injury: Advances and Challenges

Li, Qingqing; Pan, Shengqi

doi:10.2147/ijgm.s341072

Cited by 14 publications

(9 citation statements)

References 65 publications

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“…21 In addition, according to the available studies, contrast medium (CM) caused less damage in patients with normal renal function. 22 Therefore, for patients with normal renal function, even if CA-AKI occurs, its effect on renal function was negligible. And, according to Supplementary FIGURE2 , we found that the occurrence of PKI did not make a large difference in patient survival for the STAGE I group.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of dynamic evolution in renal function among patients undergoing elective percutaneous coronary intervention

Xiang

Lin

Cai

et al. 2023

Preprint

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Background: Previous studies have shown that chronic kidney disease(CKD) affected the long-term prognosis of patients underwent the elective percutaneous coronary intervention(EPCI). However, the prognostic impact in patients with the development of the contrast-associated acute kidney injury(CA-AKI) and recovery or progression of CA-AKI were controversial. For the moment, little attention has been paid to the relationship between the dynamic evolution of renal function and its prognosis. Methods: We used three stages to characterize the dynamic evolution of renal function, namely the occurrence of CKD at baseline, the occurrence of CA-AKI in the postoperative period and the occurrence of post kindey injury(PKI) at 3 - 6 months postoperatively. Cardiac death and all-cause mortality were used as the endpoint of the study. PKI(+) was defined as CA-AKI not recovered or an increase in absolute serum creatinine (SCr) {greater than or equal to}0.3 mg/dl or a SCr relative increase in creatinine {greater than or equal to} 50% after 3 - 6 months. PKI(-) was defined as CA-AKI recovered or SCr elevation not meeting the PKI(+) requirement. Results: We prospectively enrolled 2951 patients who underwent EPCI from 2012 to 2018. They were divided into three groups according to baseline CKD and CA-AKI: STAGE I[Unimpaired renal function group, CKD(-)/CA-AKI(-) (n=1247)], STAGE II[Partially impaired renal function group, IIa: CKD(-)/CA-AKI(+) (n=91) and IIb: CKD(+)/CA-AKI(-) (n=1472)] and STAGE III[severely impaired renal function group, CKD(+)/CA-AKI(+) (n=141)]. Subsequently, based on the occurrence of PKI, they were divided into six groups: STAGE I/PKI(-) (n=1212), STAGE I/PKI(+) (n=35), STAGE II/PKI(-) (n=1508), STAGE II/PKI(+) (n=55), STAGE III/PKI(-) (n=108), STAGE III/PKI(+) (n=33). In a mean follow-up period of 3.33{plus minus} 1.39 years, we found that from STAGE I, STAGE II to STAGE III at baseline groups, the incidence of the primary outcome significantly increased. Meanwhile, from the baseline groups to the follow-up groups, the dynamic changes in renal function were observed. At the follow-uo groups, the occurrence of PKI did not affect the prognosis of patients in the STAGE I group(hazard ratio [HR] = 0.94, 95%CI: 0.15-8.11, p = 0.949) and the STAGE III group(hazard ratio [HR] = 1.19, 95%CI: 0.50-2.83 p = 0.689). However, for the STAGE II group (hazard ratio [HR] = 2.65, 95%CI: 1.42-4.94, p = 0.002), the development of PKI would lead to a poor prognosis for patients. Conclusion: In patients undergoing EPCI, the occurrence of CKD and CA-AKI affected the long-term prognosis of patients. The prognostic impact of the occurrence of PKI depended on the renal function of patients. In patients with unimpaired renal function or severely impaired renal function, the prognostic impact of PKI was negligible. However, in patients with partially impaired renal function, avoidance of PKI could beneficial for their long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Prognostic impact of dynamic evolution in renal function among patients undergoing elective percutaneous coronary intervention

Xiang

Lin

Cai

et al. 2023

Preprint

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Section: Methodsmentioning

confidence: 99%

Predictors of post-stroke cognitive impairment at three-month following first episode of stroke among patients attended at tertiary hospitals in Dodoma, central Tanzania: A protocol of a prospective longitudinal observational study metadata

2023

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Introduction Neurocognitive deficits after stroke are a common manifestation and pose a significant impact on the quality of life for patients and families; however, little attention is given to the burden and associated impact of cognitive impairment following stroke. The study aims to determine the prevalence and predictors of post-stroke cognitive impairment (PSCI) among adult stroke patients admitted to tertiary hospitals in Dodoma, Tanzania. Methodology A prospective longitudinal study is conducted at tertiary hospitals in the Dodoma region, central Tanzania. Participants with the first stroke confirmed by CT/MRI brain aged ≥ 18 years who meet the inclusion criteria are enrolled and followed up. Baseline socio-demographic and clinical factors are identified during admission, while other clinical variables are determined during the three-month follow-up period. Descriptive statistics are used to summarize data; continuous data will be reported as Mean (SD) or Median (IQR), and categorical data will be summarized using proportions and frequencies. Univariate and multivariate logistic regression analysis will be used to determine predictors of PSCI.

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Section: Methodsmentioning

confidence: 99%

“…The MRI study protocol consists of 3D-T1, axial T2, 3D-FLAIR, DWI and SWI sequences. All patients will be evaluated for renal function status before undergoing brain imaging to reduce the risk of contrast-induced nephropathy (51) The stroke volume (hematoma/infarct volume) is calculated using the ellipsoid method A+B+C/2, where A represents the largest diameter, B represents the largest diameter perpendicular to A, and C represents the product of slice thickness and number of slices. A, B, and C are measured in centimetres, and the resulting volume are expressed in cm3 or milliliters (8,52) Leukoaraiosis are defined as bilateral areas of patchy or diffuse hypodensity on CT or white matter hyperintensity on MRI (Yang et al, 2015).…”

Section: Electrocardiogrammentioning

confidence: 99%

Predictors of post-stroke cognitive impairment at three-month following first episode of stroke among patients attended at tertiary hospitals in Dodoma, central Tanzania: a protocol of a prospective longitudinal observational study

Nyundo

Alphonce

Meda

2022

Preprint

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Introduction Neurocognitive deficits after stroke are a common manifestation and pose a significant impact on the quality of life for patients and families; however, little attention is given to the burden and associated impact of cognitive impairment following stroke. The study aims to determine the prevalence and predictors of post-stroke cognitive impairment (PSCI) among adult stroke patients admitted to tertiary hospitals in Dodoma, Tanzania Methodology A prospective longitudinal study is conducted at tertiary hospitals in the Dodoma region, central Tanzania. So far, participants with the first stroke confirmed by CT/MRI brain aged ≥ 18 years who meet the inclusion criteria are enrolled and followed up. Baseline socio-demographic and clinical factors are identified during admission, while other clinical variables are determined during the three-month follow-up period. Descriptive statistics are used to summarize data; continuous data will be reported as Mean (SD) or Median (IQR), and categorical data will be summarized using proportions and frequencies. Univariate and multivariate logistic regression analysis will be used to determine predictors of PSCI

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Contrast-Associated Acute Kidney Injury: Advances and Challenges

Cited by 14 publications

References 65 publications

Prognostic impact of dynamic evolution in renal function among patients undergoing elective percutaneous coronary intervention

Prognostic impact of dynamic evolution in renal function among patients undergoing elective percutaneous coronary intervention

Predictors of post-stroke cognitive impairment at three-month following first episode of stroke among patients attended at tertiary hospitals in Dodoma, central Tanzania: A protocol of a prospective longitudinal observational study metadata

Predictors of post-stroke cognitive impairment at three-month following first episode of stroke among patients attended at tertiary hospitals in Dodoma, central Tanzania: a protocol of a prospective longitudinal observational study

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