Acute kidney injury following coronary angiography is associated with a long-term decline in kidney function

• Published in: Kidney international Vol. 78; no. 8; pp. 803 - 809
• Main Authors: James, Matthew T., Ghali, William A., Tonelli, Marcello, Faris, Peter, Knudtson, Merril L., Pannu, Neesh, Klarenbach, Scott W., Manns, Braden J., Hemmelgarn, Brenda R.
• Format: Journal Article
• Language: English
• Published: Basingstoke Elsevier Inc 01.10.2010; Nature Publishing Group; Elsevier Limited
• Subjects: acute kidney injury; Acute Kidney Injury - etiology; Aged; Aged, 80 and over; Biological and medical sciences; Cardiology. Vascular system; chronic renal disease; Coronary Angiography - adverse effects; coronary artery disease; Coronary heart disease; Creatine - blood; Female; Follow-Up Studies; Glomerular Filtration Rate; Heart; Humans; Kidney - physiopathology; Kidney Function Tests; Kidneys; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Time Factors; Urinary system involvement in other diseases. Miscellaneous; coronary artery disease; acute kidney injury; glomerular filtration rate; chronic renal disease; Kidney disease; Nephrology; Urinary system disease; Renal function; Radiodiagnosis; Acute kidney injury; Cardiovascular disease; Chronic kidney disease; Coronary arteriography; Coronary heart disease; Long term; Urology; Glomerular filtration rate; Renal failure
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.2010.258

To determine whether acute kidney injury results in later long-term decline in kidney function we measured changes in kidney function over a 3-year period in adults undergoing coronary angiography who had serum creatinine measurements as part of their clinical care. Acute kidney injury was categorized by the magnitude of increase in serum creatinine (mild (50–99% or ≥0.3mg/dl) and moderate or severe (≥100%)) within 7 days of coronary angiography. Compared to patients without acute kidney injury, the adjusted odds of a sustained decline in kidney function at 3 months following angiography increased more than 4-fold for patients with mild to more than 17-fold for those with moderate or severe acute kidney injury. Among those with an estimated glomerular filtration rate after angiography less than 90ml/min per 1.73m2, the subsequent adjusted mean rate of decline in estimated glomerular filtration rate during long-term follow-up (all normalized to 1.73m2 per year) was 0.2ml/min in patients without acute kidney injury, 0.8ml/min following mild injury, and 2.8ml/min following moderate to severe acute kidney injury. Thus, acute kidney injury following coronary angiography is associated with a sustained loss and a larger rate of future decline in kidney function.