Acute Kidney Injury Risk Factors Development During Myocardial Infarction in Young and Middle-Age Men With Gout

Abstract

Abstract. Relevance. Acute kidney injury (AKI) in myocardial infarction worsens the prognosis and increases the duration of treatment of patients. Aim. To evaluate predictors of acute kidney injury in myocardial infarction in men younger than 60 years of age with gout to assess opportunities to improve prevention. Material and methods. The study included men 42-59 years old (y.o.) with type I MI and gout. Patients were divided into two age-comparable groups: I - study group, with AKI - two pa-tients; II - control, without it - 24 patients. Comparative evaluation of data on cardiovascular risk factors, parameters of the disease course in selected groups was performed. Quantitative parameters were determined twice, in the first 48 hours (1) and at the end of the third week (2) of MI. Pearson's chi-square method was used to assess the absolute (AR) and relative (RR) risks of developing AKI under the influence of the listed factors. Results. A significant effect on the possibility of developing AKI in the examined patients was obtained for: a history of urolithiasis (AR 50.0%; p=0.01), MI in the winter period (AR 40.0%; p=0.03 ); levels of low-density lipoproteins1<2.5 mmol/l (AR 50.0%; p=0.04), ratios of total cholesterol1/high-density lipoproteins1<3.7 (AR 50.0%; p=0.04), glucose1 ≥8.9 mmol/l (AR 100.0%; RR 14.0; p=0.008); potassium1 ˂3.8 mmol/l (AR 100.0%; RR 13.0; p=0.01), glomerular filtration rate (СKD-EPI)1≥123.0 ml/min/1.73 m2 (AR 100.0%; RR 14.0, p=0.008); polytopic extrasystole (AR 100.0%; RR 14.0; p=0.008), thromboembolism (AR 100.0%; RR 14.0; p=0.08) in the structure of MI complications; levels of systolic blood pres-sure (BPsyst)1≥200 mm Hg. (AR 66.7%; p=0.002), mean BP1≥133.0 (AR 66.7%; p=0.002), stroke index1≥39.8 ml/m2 (AR 66.7%; p=0.002), transverse dimension of the right atrium (RA)1 ˃52 mm (AR 50.0%; p=0.01). Conclusions. The most important for the risk of AKI development during MI in men under 60 y.o. with gout were arterial hypertension (BPsyst≥200 mHg), hyperglycemia (≥8.9 mmol/l), RA dilation (˃52 mm), history of urolithiasis. Combinations of the above parameters should be used to form high-risk groups for AKI development in this category of patients to improve preventive measures, as well as for predictive modeling.