scholarly journals Association of prealbumin levels with contrast-induced acute kidney injury in elderly patients with elective percutaneous coronary intervention

2018 ◽  
Vol Volume 13 ◽  
pp. 641-649 ◽  
Author(s):  
ZheBin You ◽  
KaiYang Lin ◽  
WeiPing Zheng ◽  
ChunJin Lin ◽  
Fan Lin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Elderly Patients ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary

scholarly journals Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention

2021 ◽  
Author(s):  
Xiaoqi Wei ◽  
Hanchuan Chen ◽  
Zhebin You ◽  
Jie Yang ◽  
Haoming He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Severe Malnutrition ◽  
Percutaneous Coronary ◽  
Conut Score

Abstract Background This study aimed to investigate the connection between malnutrition evaluated by the Controlling Nutritional Status (CONUT) score and the risk of contrast-associated acute kidney injury (CA-AKI) in elderly patients who underwent percutaneous coronary intervention (PCI). Methods A total of 1308 patients aged over 75 years undergoing PCI was included. Based on the CONUT score, patients were assigned to normal (0–1), mild malnutrition (2–4), moderate-severe malnutrition group (≥ 5). The primary outcome was CA-AKI (an absolute increase in ≥ 0.3 mg/dL or ≥ 50% relative serum creatinine increase 48 h after contrast medium exposure). Results Overall, the incidence of CA-AKI in normal, mild, moderate-severe malnutrition group was 10.8%, 11.0%, and 27.2%, respectively (p < 0.01). Compared with moderate-severe malnutrition group, the normal group and the mild malnutrition group showed significant lower risk of CA-AKI in models adjusting for risk factors for CA-AKI and variables in univariate analysis (odds ratio [OR] = 0.48, 95% confidence interval [CI]: 0.26–0.89, p = 0.02; OR = 0.46, 95%CI: 0.26–0.82, p = 0.009, respectively). Furthermore, the relationship were consistent across the subgroups classified by risk factors for CA-AKI except anemia. The risk of CA-AKI related with CONUT score was stronger in patients with anemia. (overall interaction p by CONUT score = 0.012). Conclusion Moderate-severe malnutrition is associated with higher risk of CA-AKI in elderly patients undergoing PCI.

Neutrophil gelatinase associated lipocalin, an early biomarker for diagnosis of acute kidney injury after percutaneous coronary intervention

2017 ◽  
Vol 43 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Nakhshab Choudhry ◽  
Amna Ihsan ◽  
Sadia Mahmood ◽  
Fahim Ul Haq ◽  
Aamir Jamal Gondal
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Diagnostic Biomarker ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
The Mean

AbstractObjectives:This study was designed to find the reliability of serum NGAL as an early and better diagnostic biomarker than that of serum creatinine for acute kidney injury after percutaneous coronary intervention in Pakistani population.Materials and methods:One hundred and fifty-one patients undergoing elective percutaneous coronary intervention were included and demographic data were recorded. Blood was drawn by venipuncture in clot activator vacutainers and serum was separated and stored at 4°C. Sample was drawn before the percutaneous procedure and subsequently sampling was done serially for 5 days.Results:The mean±SD serum NGAL pre-PCI (39.92± 10.35 μg/L) and 4 h post-PCI (100.42±26.07 μg/L) showed highly significant difference (p<0.001). The mean±SD serum creatinine pre-PCI (70.1±11.8 μmol/L) and post-PCI (71.2±11.6 μmol/L) showed significant difference (p=0.005) on day 2 onwards but mean microalbumin showed insignificant results (p=0.533). The serum NGAL predicted CI-AKI with sensitivity of 95.8% and specificity of 97.6% for a cut off value of 118 μg/L.Conclusion:Our results suggest that NGAL is an excellent early diagnostic biomarker for acute kidney injury in patients undergoing elective percutaneous coronary intervention.

P5532Predictive value of objective nutritional scores for contrast-induced acute kidney injury in elderly patients undergoing percutaneous coronary intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Lin ◽  
L Chen ◽  
L Chen ◽  
C Han ◽  
C Han ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Left Ventricular Ejection ◽  
Percutaneous Coronary ◽  
Conut Score

Abstract Background Age >75 years had been generally considered to be an important and independent risk factor of contrast-induced acute kidney injury (CI-AKI), while these patients often suffer from malnutrition. However, the predictive value of objective nutritional status for CI-AKI in elderly patients undergoing percutaneous coronary intervention (PCI) remains unknown. Purpose To evaluate the association of two kinds of objective nutritional indices includes controlling nutritional (CONUT) score and prognostic nutritional index (PNI) with CI-AKI in elderly patients undergoing PCI. Methods In a single center prospective cohort study,we enrolled 714 consecutive patients who aged >75 years undergoing PCI between January 2012 and December 2015 were screened based on their serum albumin, lymphocyte count, and total cholesterol measures. Patients were stratified into different groups according to two kinds of objective nutritional scores. Patients were divided into low-PNI (PNI <35), middle-PNI (35 ≤ PNI <38), and high-PNI (PNI ≥38). They were also divided into four groups according to CONUT score: normal-CONUT (0–1), mild-CONUT (2–4), moderate-CONUT (5–8), and severe-CONUT (≥9). CI-AKI was defined as an increase in the serum creatinine levels of ≥50% or 0.3 mg/dL above the baseline level within 48hrs after contrast medium exposure. Results Overall, 55 (7.7%) had moderate-severe CONUT scores, and 35 (4.9%) had low-middle PNI scores,while 93 (13.0%) patients developed CI-AKI. Patients with a lower PNI score or higher CONUT score had significantly higer incidence of CI-AKI [PNI score: high (11.8%), middle (33.3%), and low (45.5%), respectively; P<0.0001; CONUT score: normal (9.6%), mild (12.7%), moderate (30.2%), and severe (100%), respectively; P<0.0001]. After adjusting 6 confounders, including age, serum creatinine (SCR) >1.5mg/dl, left ventricular ejection fraction (LEVF) <45%, myocardial infarction, peri-hypotension and the contrast volume >200 ml, multivariate analysis showed that worse objective nutritional status (either lower PNI scores or higer CONUT scores) was associated with an increased CI-AKI risk (Low PNI vs High PNI: OR: 5.274, P=0.015; Moderate-Severe CONUT vs Normal CONUT: OR: 2.891, P=0.007). Incidence of CIAKI Conclusions Worse objective nutritional status was associated with CI-AKI in elderly patients after PCI.

scholarly journals Overconsumption of Contrast Media in Percutaneous Coronary Intervention: Focusing on Cost and Acute Kidney Injury

2019 ◽  
Author(s):  
Marziye Jafari ◽  
Gohar Eslami ◽  
Babak Bagheri ◽  
Shirin Asghari Vaskasi ◽  
Shafagh Eslami
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Contrast Media ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Evaluation Study ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Standard Values ◽  
Periodic Evaluation

Irrational use of medicines is a major problem worldwide. Since iodixanol (Visipaque®) was categorized in Category I based on the ABC-VED analysis in our hospital, we evaluated the amount of visipaque use and estimated the incremental cost based on the Maximum Contrast Dose (MCD) following irrational use of contrast media. This retrospective study was conducted on 100 admitted patients aged 18 to 80 years old undergoing elective Percutaneous Coronary Intervention (PCI) who received visipaque during February 2016 to January 2017. All of the patients’ information was collected from medical records and Hospital Information System (HIS). MCD was calculated by using the formula proposed by Cigarroa and colleagues: MCD (mL) =5× body weight (kg)/ Serum Creatinine (SCr) (mg/dl). The amount of contrast media administered ranged from 200 to 600 mL (mean, 348 mL ± 80). 57 % of patients received the visipaque more than MCD. Only 25 patients were evaluated SCr after PCI and in 11 (44%) of these patients SCr increased and 3 (12%) patients developed CI-AKI. Consumption of the contrast media was 2 to 3 times more than previous studies which could be the cause of acute kidney injury besides the extra cost. In our study about six liters more of contrast agent was used which is more than standard values with a cost of approximately $2,000 for 100 patients. Therefore, in order to reduce costs and complications, appropriate clinical protocol of contrast media, more supervision on medical residents and contrast infusion pumps, as well as a periodic evaluation study are highly recommended.

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