Population attributable risk estimates of risk factors for contrast-induced acute kidney injury following coronary angiography: a cohort study

• Published in: BMC cardiovascular disorders Vol. 20; no. 1; pp. 289 - 8
• Main Authors: Lei, Li, Xue, Yan, Guo, Zhaodong, Liu, Bowen, He, Yibo, Song, Feier, Liu, Jin, Sun, Guoli, Chen, Liling, Chen, Kaihong, Su, Zhiqi, Pan, Li, Huang, Zhidong, Huang, Yulu, Huang, Xiuqiong, Chen, Shiqun, Chen, Jiyan, Liu, Yong
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.06.2020; BioMed Central; BMC
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - chemically induced; Acute Kidney Injury - diagnosis; Acute Kidney Injury - epidemiology; Acute renal disease; Aged; Aged, 80 and over; Angiography; Biomarkers - blood; Catheterization; China - epidemiology; Chronic kidney failure; Cohort analysis; Complications and side effects; Congestive heart failure; Contrast Media - adverse effects; Coronary angiography; Coronary Angiography - adverse effects; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Artery Disease - therapy; Creatinine; Creatinine - blood; Female; Health risk assessment; Heart Failure - epidemiology; Humans; Hypoalbuminemia - epidemiology; Hypotension; Hypotension - epidemiology; Incidence; Kidney diseases; Male; Medical imaging; Middle Aged; Mortality; Myocardial infarction; Percutaneous Coronary Intervention - adverse effects; Population attributable risk; Population studies; Prevalence; Risk Assessment; Risk Factors; Studies; Time Factors; Trinucleotide repeats; Up-Regulation; China; Acute renal disease; Catheterization; Population attributable risk; Risk factors
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-020-01570-6

Contrast-induced acute kidney injury (CI-AKI) is a common complication with poor outcomes following coronary angiography (CAG) or percutaneous coronary intervention (PCI). However, no study has explored the population attributable risks (PARs) of the CI-AKI risk factors. Therefore, we aimed to identify the independent risk factors of CI-AKI and estimate their PARs. We analyzed 3450 consecutive patients undergoing CAG/PCI from a prospective cohort in Guangdong Provincial People's Hospital. CI-AKI was defined as a serum creatinine elevation ≥50% or 0.3 mg/dL from baseline within the first 48 to 72 h after the procedure. Independent risk factors for CI-AKI were evaluated through stepwise approach and multivariable logistic regression analysis, and those that are potentially modifiable were of interest. PARs of independent risk factors were calculated with their odds ratios and prevalence among our cohort. The overall incidence of CI-AKI was 7.19% (n = 248), which was associated with increased long-term mortality. Independent risk factors for CI-AKI included heart failure (HF) symptoms, hypoalbuminemia, high contrast volume, hypotension, hypertension, chronic kidney disease stages, acute myocardial infarction and age > 75 years. Among the four risk factors of interest, the PAR of HF symptoms was the highest (38.06%), followed by hypoalbuminemia (17.69%), high contrast volume (12.91%) and hypotension (4.21%). These modifiable risk factors (e.g., HF symptoms, hypoalbuminemia) could be important and cost-effective targets for prevention and treatment strategies to reduce the risk of CI-AKI. Intervention studies targeting these risk factors are needed.