Impact of Serum Albumin Levels on Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention

Abstract

Patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI) are at high risk of contrast-induced acute kidney injury (CI-AKI), a complication associated with poor clinical outcomes. Serum albumin (SA) levels are associated with cardiovascular mortality. We assessed the association between SA levels and the risk of CI-AKI in patients with ACS (n = 890) treated with PCI. Patients were divided into 2 groups: patients with and without CI-AKI. Contrast-induced acute kidney injury was defined as an increase in serum creatinine (≥25% or ≥0.5 mg/dL) from baseline occurring 72 hours after PCI. The SA levels were significantly lower in patients with CI-AKI than in those without CI-AKI (3.52 ± 0.40 vs 3.94 ± 0.39 mg/dL, P < .001). On multivariate analysis, SA was an independent predictor of CI-AKI (odds ratio 0.177, 95% confidence interval 0.080-0.392, P < .001) together with age, female gender, creatine kinase-myocardial band, and glomerular filtration rate. Baseline SA levels are inversely associated with CI-AKI after PCI for ACS.

Usefulness of The C‐Reactive Protein/Albumin Ratio for Predicting No‐Reflow in ST‐elevation myocardial infarction treated with primary percutaneous coronary intervention

“…It has been established that a decrease in SA level is related to poor in-hospital survival as well as in-stent restenosis, coronary artery disease severity and contrast-induced acute kidney injury. [25][26][27] It has been noted that a decrease in albumin levels and an increase in CRP can be linked to an STEMI patient's NR. [9][10][11] The pathophysiological role is, however, not completely comprehended.…”

Causal relationship between hypoalbuminemia and acute kidney injury

“…They also acknowledged that their post-hoc analysis used a carefully selected cohort drawn from the DOSE-AHF and ROSE-AHF trials that were inadequately powered to detect clinical end points according to baseline albumin, and that their findings may not be generalizable. A separate study, by Murat et al[21], retrospectively looked at the impact of serum albumin levels on AKI occurrence in a cohort of 890 patients with acute coronary syndromes (ACS) treated with percutaneous coronary intervention (PCI). Serum albumin was inversely associated with AKI risk and, along with a number of other variables [age, female gender, creatinine kinase-myocardial band, and glomerular filtration rate (GFR)], was independently predictive of AKI occurrence.…”

Risk factors and outcomes of contrast-induced nephropathy in hospitalised South Africans

“…Serum albumin is an important renoprotective, anti-inflammatory and antioxidant agent acting via several mechanisms; serum albumin binds non-ceruloplasmin copper and iron, which are important in the formation of ROS, and maintains renal perfusion by dilating renal vessels via its binding to nitrogen oxide, forming S-nitro-albumin. [12,[23][24][25][26] However, during inflammation, albumin synthesis is reduced and activated neutrophils increase the levels of hypochlorous acid, which inactivates albumin. [12,13,23] Low serum albumin is probably a biomarker reflecting baseline susceptibility to acute or chronic inflammation or undernutrition.…”

“…[12,[23][24][25][26] However, during inflammation, albumin synthesis is reduced and activated neutrophils increase the levels of hypochlorous acid, which inactivates albumin. [12,13,23] Low serum albumin is probably a biomarker reflecting baseline susceptibility to acute or chronic inflammation or undernutrition. In two previous studies, Murat et al [23] and Song et al [24] found a positive association between low serum albumin and an increased risk for the development of CIN.…”

“…[12,13,23] Low serum albumin is probably a biomarker reflecting baseline susceptibility to acute or chronic inflammation or undernutrition. In two previous studies, Murat et al [23] and Song et al [24] found a positive association between low serum albumin and an increased risk for the development of CIN. A meta-analysis showed a positive association between decreased serum albumin and development of AKI, as well as increased morbidity and mortality.…”