A simple proteinuria-based risk score predicts contrast-associated acute kidney injury after percutaneous coronary intervention

• Published in: Scientific reports Vol. 12; no. 1; p. 12331
• Main Authors: Fujiwara, Wakaya, Ishii, Hideki, Sobue, Yoshihiro, Shimizu, Shinya, Ishiguro, Tomoya, Yamada, Ryo, Ueda, Sayano, Nishimura, Hideto, Niwa, Yudai, Miyazaki, Akane, Miyagi, Wataru, Takahara, Shuhei, Naruse, Hiroyuki, Ishii, Junichi, Kiyono, Ken, Watanabe, Eiichi, Izawa, Hideo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 19.07.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4019/2776; 692/53/2423; Angioplasty; Calibration; Correlation coefficient; Creatinine; Datasets; Emergency procedures; Humanities and Social Sciences; Kidneys; multidisciplinary; Proteinuria; Renal function; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-16690-6

Contrast-associated acute kidney injury (CA-AKI) is a complication of percutaneous coronary intervention (PCI). Because proteinuria is a sentinel marker of renal dysfunction, we assessed its role in predicting CA-AKI in patients undergoing PCI. A total of 1,254 patients undergoing PCI were randomly assigned to a derivation ( n  = 840) and validation ( n  = 414) dataset. We identified the independent predictors of CA-AKI where CA-AKI was defined by the new criteria issued in 2020, by a multivariate logistic regression in the derivation dataset. We created a risk score from the remaining predictors. The discrimination and calibration of the risk score in the validation dataset were assessed by the area under the receiver-operating characteristic curves (AUC) and Hosmer–Lemeshow test, respectively. A total of 64 (5.1%) patients developed CA-AKI. The 3 variables of the risk score were emergency procedures, serum creatinine, and proteinuria, which were assigned 1 point each based on the correlation coefficient. The risk score demonstrated a good discriminative power (AUC 0.789, 95% CI 0.766–0.912) and significant calibration. It was strongly associated with the onset of CA-AKI (Cochran-Armitage test, p  < 0.0001). Our risk score that included proteinuria was simple to obtain and calculate, and may be useful in assessing the CA-AKI risk before PCI.