Author + information
- S1936879815020816-b41fe52590ef8bb393cebb8b291037bfArie Steinvil,
- S1936879815020816-bf29c8f13fbb53b703a3aa00bd1aca7cHector M. Garcia-Garcia,
- S1936879815020816-bb7d56defc47dfa50850f194a4d010d0Toby Rogers,
- S1936879815020816-22ca6bb575feb9b0401e73b8ef13bd3aSarkis Kiramijyan,
- S1936879815020816-e1d8ab303901814b3704944324375e3fEddie Koifman,
- S1936879815020816-05002cb46075934f124e1def1fbd79a4Smita Negi,
- S1936879815020816-a6c1bc52851ff7a2f92d51d27345d37fSang Yeub Lee,
- S1936879815020816-43188b297454714a1e633ce32956ff39Rebecca Torguson,
- S1936879815020816-1afcf597a9ea0e6a884d08efd238ef1fLowell F. Satler,
- S1936879815020816-3a0d6b08f0725219bdf768375029e047Michael Lipinski,
- S1936879815020816-201053be4677f8934b7a048e96b4f4b5Michael Gaglia,
- S1936879815020816-280150bfca3f0be2b424079de79e87c6Itsik Ben-Dor and
- S1936879815020816-772b1cb1fca98a9f26e1e7f8bddc725bRon Waksman
Acute kidney injury (AKI) is a frequent complication following percutaneous coronary intervention (PCI). The current definitions limit its occurrence to 48-hour following the procedure which may cause underestimation of the real-life incidence of kidney injury following PCI.
We analyze the data of a large single center registry of patients undergoing PCI between the years 2000-2014. We report on the AKI rates, correlates and trends using a wider definition for AKI without a strict temporal limitation.
The study included 22,306 patients with a mean age (±SD) of 64.84±12.33 of whom 66% were males and 19% presented with ST segment elevation myocardial infarction(STEMI). AKI of any grade occurred in10.6%, dialysis was needed in 28 patients. In multivariate analysis, age, race, eGFR, diabetes mellitus, congestive heart failure, extent of myocardial injury, as well as post procedural bleeding and vascular complications were all found to correlate with AKI. Contrast volume was forced in the analysis, however was not found significant. Patients with AKI were more likely to have longer in hospital and intensive care unit stays, and higher rates of major adverse cardiovascular outcomes and death. In trend analysis between the years 2000-2014, we did not find a linear reduction of AKI rates (p for trend=0.718). This was mainly due to an unpredicted surge in AKI events from baseline, occurring in 2011 with AKI rates of 20% (p for trend=0.04) followed thereafter by stricter adherence to current guidelines and implementation of anti AKI measures which significantly reduced the AKI rates to similar rates as before at about 6% (p=0.05).
AKI rates in a real life setting change during a prolonged period of time. Physician awareness and implementation of anti AKI measures may help to reduce peaks to nadirs.