scholarly journals Effect of statins on post-contrast acute kidney injury: a multicenter retrospective observational study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Maoning Lin ◽  
Tian Xu ◽  
Wenjuan Zhang ◽  
Duannbin Li ◽  
Ya Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Observational Study ◽  
Protective Effect ◽  
Kidney Injury ◽  
Retrospective Observational Study ◽  
Lipid Lowering ◽  
Post Contrast ◽  
Lowering Effect ◽  
Lipid Lowering Effect ◽  
Inflammatory Effect

Abstract Background Post-contrast acute kidney injury (PC-AKI) is a severe complication of coronary angiography (CAG) and percutaneous coronary intervention (PCI). Currently, the effect of statins on PC-AKI and its mechanism remains unclear. Methods This multicenter retrospective observational study included 4386 patients who underwent CAG or PCI from December 2006 to December 2019 in Sir Run Run Shaw Hospital and its medical consortium hospitals. Serum creatinine pre- or post-procedure within 72 h after PCI was recorded. Multivariate logical regression was used to explore whether preoperative use of statins was protective from PC-AKI. The path analysis model was then utilized to look for the mediation factors of statins. Results Four thousand three hundred eighty-six patients were enrolled totally. The median age of the study population was 68 years old, 17.9% with PC-AKI, and 83.3% on preoperative statins therapy. The incidence of PC-AKI was significantly lower in group of patients on statins therapy. Multivariate regression indicated that preoperative statins therapy was significantly associated with lower percentage of elevated creatinine (β: -0.118, P < 0.001) and less PC-AKI (OR: 0.575, P < 0.001). In the preoperative statins therapy group, no statistically significant difference was detected between the atorvastatin and rosuvastatin groups (OR: 1.052, P = 0.558). Pathway model analysis indicated a direct protective effect of preoperative statins therapy on PC-AKI (P < 0.001), but not through its lipid-lowering effect (P = 0.277) nor anti-inflammatory effect (P = 0.596). Furthermore, it was found that “low-density lipoprotein cholesterol (LDL-C)→C-reactive protein (CRP)” mediated the relationship between preoperative statins therapy and PC-AKI (P = 0.007). However, this only explained less than 1% of the preoperative protective effects of statins on PC-AKI. Conclusion Preoperative statins therapy is an independent protective factor of PC-AKI, regardless of its type. This protective effect is not achieved by lipid-lowering effect or anti-inflammatory effect. These findings underscore the potential use of statins in preventing PC-AKI among those at risk.

scholarly journals The Effect and Underlying Mechanism of Statins in the Prevention of Post-Contrast Acute Kidney Injury: A Multicenter Retrospective Observational Study

2021 ◽  
Author(s):  
Maoning Lin ◽  
Tian Xu ◽  
Wenjuan Zhang ◽  
Duanbin Li ◽  
Ya Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Path Analysis ◽  
Statin Therapy ◽  
Protective Factor ◽  
Therapy Group ◽  
Kidney Injury ◽  
Lipid Lowering ◽  
Post Contrast ◽  
Lipid Lowering Effect ◽  
Inflammatory Effect

Abstract Background: Post-Contrast acute kidney injury (PC-AKI) is a severe complication of coronary angiography (CAG) and percutaneous coronary intervention (PCI). At present, the mechanism and effect of statins on PC-AKI and its mechanism are still unclear. Methods: It was a multicenter retrospective obeservational study. We reviewed 4386 patients who underwent CAG or PCI, with serum creatinine recorded pre- or post-procedure within 72hrs after PCI, from December, 2006 to December, 2019 admitted to Sir Run Run Shaw Hospital and its medical consortium hospitals. Multivariate logical regression was used to explore whether preoperative use of statins was a protective factor for PC-AKI, and then path analysis model was used to explore the specific mechanism of statins. Results: In total, 4386 patients were enrolled in the study, the mean age was 67 yrs old, 17.9% with PC-AKI, 83.3% with pre-operative statin therapy. The incidence of PC-AKI was significantly lower in statin therapy group than non-statins therapy group. Multivariate regression indicated that pre-operative statin therapy was significantly negatively associated with percentage of elevated creatinine (β: -0.118, p<0.001) and PC-AKI (OR: 0.575, p<0.001). In pre-operative statin therapy group, no statistically significant deference was detected between atorvastatin and rosuvastatin group (OR: 1.052, p=0.558). Pathway model analysis indicated the direct protective effectiveness of pre-operative statin therapy on PC-AKI (p<0.001), but neither with its lipid-lowering effect (p=0.277) nor anti-inflammatory effect (p=0.596). Furthermore, It was found that “LDL-C→CRP” mediated the relationship between pre-operative statin therapy and PC-AKI (p=0.007); however, only explained less than 1% of the pre-operative statin therapy’s protective effects on PC-AKI. Conclusion: Pre-operative statin therapy is an independent protective factor of PC-AKI, which is not affected by the type of statins and not achieved by lipid-lowering effect or anti-inflammatory effect. Keywords : post-contrast acute kidney injury, statins, path analysis, mediation analysis.

INCIDENCE OF ACUTE KIDNEY INJURY IN NEUROSURGICAL PATIENTS TREATED WITH HYPERTONIC SALINE: RETROSPECTIVE OBSERVATIONAL STUDY

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A981
Author(s):  
Sasa Ivanovic ◽  
Aimen Liaqat ◽  
Kristin Fless ◽  
Vagram Ovnanian ◽  
Fariborz Rezai ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Observational Study ◽  
Hypertonic Saline ◽  
Kidney Injury ◽  
Retrospective Observational Study ◽  
Neurosurgical Patients

scholarly journals Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China: A single-center retrospective observational study

2020 ◽  
Author(s):  
Guanhua Xiao ◽  
Hongbin Hu ◽  
Feng Wu ◽  
Tong Sha ◽  
Qiaobing Huang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Observational Study ◽  
White Blood Cells ◽  
Protein A ◽  
Kidney Injury ◽  
Retrospective Observational Study ◽  
Single Center ◽  
Logistic Regression Models ◽  
Computed Tomographic ◽  
D Dimer

AbstractBackgroundThe kidney may be affected in coronavirus-2019 disease (COVID-19). This study assessed the predictors and outcomes of acute kidney injury (AKI) among individuals with COVID-19.MethodsThis observational study, included data on all patients with clinically confirmed COVID-19 admitted to Hankou Hospital, Wuhan, China from January 5 to March 8, 2020. Data were extracted from clinical and laboratory records. Follow-up was censored on March 8, 2020.This is a single-center, retrospective, observational study. Patients clinically confirmed COVID-19 and admitted to Hankou Hospital, Wuhan, China from January 5 to March 8, 2020 were enrolled. We evaluated the association between changes in the incidence of AKI and COVID-19 disease and clinical outcomes by using logistic regression models.ResultsA total of 287 patients, 55 with AKI and 232 without AKI, were included in the analysis. Compared to patients without AKI, AKI patients were older, predominantly male, and were more likely to present with hypoxia and have pre-existing hypertension and cerebrovascular disease. Moreover, AKI patients had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3%, and the incidence of stage 2 or 3 AKI was 4.9%. Patients with AKI had substantially higher mortality.ConclusionsAKI is an important complication of COVID-19. Older age, male, multiple pre-existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions were the risk factors of AKI. AKI patients who progressed to stages 2 or 3 AKI had a higher mortality rate. Prevention of AKI and monitoring of kidney function is very important for COVID-19 patients.Trial registrationNCT04316299(03/19/2020)

Sign in / Sign up

Export Citation Format

Share Document