Predictive value of preprocedural albuminuria for contrast-induced nephropathy non-recovery in patients undergoing percutaneous coronary intervention

Abstract

Objective The present study investigated the predictive value of albuminuria for contrast-induced nephropathy (CIN) non-recovery in patients undergoing percutaneous coronary intervention (PCI). Methods We retrospectively enrolled 550 consecutive patients inflicted with CIN after PCI and reassessing kidney function among 1 week–12 months between January 2012 and December 2018. Patients were stratified into three groups according to urine albumin: negative group (urine dipstick negative), trace group (urine dipstick trace) and positive group (urine dipstick ≥ 1 +). The primary outcomes were CIN non-recovery (a decrease of serum creatinine which remains ≥ 25% or 0.5 mg/dL over baseline at 1 week–12 months after PCI in patients inflicted with CIN). The odds ratio (OR) of CIN non-recovery was analyzed by logistic regression using the negative urine dipstick group as the reference group. Results Overall, 88 (16.0%) patients had trace urinary albumin, 74 (13.5%) patients had positive urinary albumin and 40 (7.3%) patients developed CIN non-recovery. Patients with positive urinary albumin had significantly higher incidence of CIN non-recovery [negative (3.4%), trace (11.4%) and positive (23.0%), respectively; P < 0.0001]. Multivariate analysis showed that trace and positive urinary albumin were associated with an increased risk of CIN non-recovery (trace vs negative: OR 2.88, P = 0.022; positive vs negative: OR 2.99, P = 0.021). These associations were consistent in subgroups of patients stratified by CIN non-recovery risk predictors. And CIN non-recovery was associated with an increased risk of long-term mortality during a mean follow-up period of 703 days (P < 0.001). Conclusion Preprocedural albuminuria was associated with CIN non-recovery in patients undergoing PCI.

Interleukin-18 and Gelsolin Are Associated with Acute Kidney Disease after Cardiac Catheterization

“…Additionally, previous studies have revealed that the incidence of contrast-associated AKI might be relatively lower during the immediate post-exposure period (24–36 h), and contrast-associated renal damage could become more prominent 2–5 days after exposure [ 3 , 4 , 29 ]. Considering the surrogate role of albuminuria for kidney damage [ 30 , 31 ] and the time-course variations of renal injury after contrast exposure, our study emphasized the requirement for serial monitoring of serum Cr and albuminuria (or other reliable renal biomarkers) in patients undergoing cardiac catheterization, especially in the high-risk population.…”