Post-contrast acute kidney injury in a hospitalized population: short-, mid-, and long-term outcome and risk factors for adverse events

Cheng, Wei; Wu, Xiaoxiang; Liu, Qian; Wang, Hongshen; Zhang, Ning-Ya; Xiao, Yuzhong; Yan, Ping; Li, Xuwei; Duan, Xiangjie; Peng, Jing-Cheng; Feng, Shuang; Duan, Shao‐Bin

doi:10.1007/s00330-020-06690-3

Cited by 24 publications

(17 citation statements)

References 59 publications

(66 reference statements)

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“…As studies have consistently shown that an episode of AKI was associated with increased risks for requirement of renal replacement therapy, subsequent CKD and mortality ( Bucaloiu et al, 2012 ; Cheng et al, 2020 ; Hoste et al, 2018 ; Linder et al, 2014 ), whether the association between AKD and adverse outcomes in 30 days and one year was resulted from the impact of AKI stage was unclear. Therefore, we stratified the patients by both AKI stage and AKD stage.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney disease in hospitalized acute kidney injury patients

Yan

Duan

Liu

et al. 2021

PeerJ

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Background Acute kidney injury (AKI) and chronic kidney disease (CKD) have become worldwide public health problems, but little information is known about the epidemiology of acute kidney disease (AKD)—a state in between AKI and CKD. We aimed to explore the incidence and outcomes of hospitalized patients with AKD after AKI, and investigate the prognostic value of AKD in predicting 30-day and one-year adverse outcomes. Methods A total of 2,556 hospitalized AKI patients were identified from three tertiary hospitals in China in 2015 and followed up for one year.AKD and AKD stage were defined according to the consensus report of the Acute Disease Quality Initiative 16 workgroup. Multivariable regression analyses adjusted for confounding variables were used to examine the association of AKD with adverse outcomes. Results AKD occurred in 45.4% (1161/2556) of all AKI patients, 14.5% (141/971) of AKI stage 1 patients, 44.6% (308/691) of AKI stage 2 patients and 79.6% (712/894) of AKI stage 3 patients. AKD stage 1 conferred a greater risk of Major Adverse Kidney Events within 30 days (MAKE30) (odds ratio [OR], 2.36; 95% confidence interval 95% CI [1.66–3.36]) than AKD stage 0 but the association only maintained in AKI stage 3 when patients were stratified by AKI stage. However, compared with AKD stage 0, AKD stage 2–3 was associated with higher risks of both MAKE30 and one-year chronic dialysis and mortality independent of the effects of AKI stage with OR being 31.35 (95% CI [23.42–41.98]) and 2.68 (95% CI [2.07–3.48]) respectively. The association between AKD stage and adverse outcomes in 30 days and one year was not significantly changed in critically ill and non-critically ill AKI patients. The results indicated that AKD is common among hospitalized AKI patients. AKD stage 2–3 provides additional information in predicting 30-day and one-year adverse outcomes over AKI stage. Enhanced follow-up of renal function of these patients may be warranted.

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Section: Discussionmentioning

confidence: 99%

Acute kidney disease in hospitalized acute kidney injury patients

Yan

Duan

Liu

et al. 2021

PeerJ

Self Cite

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“…Cheng et al reported that oliguria was an independent risk factor of 90-day or 1-year adverse prognosis (P<0.05) in hospitalized patients with post-contrast acute kidney injury. 26 Similarly, a nationwide survey of patients with AKI revealed that oliguria occurrence at the time of AKI diagnosis was an independently significant prognostic indicator of in-hospital mortality. 27 Transient oliguria may have a relatively benign nature; however, it is still a symptom of which clinicians must remain aware.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus as a Risk Factor for Progression from Acute Kidney Injury to Acute Kidney Disease: A Specific Prediction Model

Zhao

Liang

Pan

et al. 2021

DMSO

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Acute kidney injury is very common in hospitalized patients and carries a significant risk of mortality. Although timely intervention may improve patient prognosis, studies on the development of acute kidney disease in patients with acute kidney injury remain scarce. Thus, we constructed a prediction model to identify patients likely to develop acute kidney disease. Patients and Methods: Among 474 patients screened for eligibility, 261 were enrolled and randomly divided into training (185 patients) and independent validation cohorts (76 patients). Least absolute shrinkage and selection operator regression and multivariate logistic regression analyses were used to select features and build a nomogram incorporating the selected predictors: diabetes, anemia, oliguria, and peak creatinine. Calibration, discrimination, and the clinical usefulness of the model were assessed using calibration plots, the C-index, receiver operating characteristic curves, and decision curve analysis. Results: Diabetes was significantly associated with the presence of AKD. Peak creatinine, oliguria, and anemia also contributed to the progression of acute kidney injury. The model displayed good predictive power with a C-index of 0.834 and an AUC of 0.834 (95% confidence interval (CI): 0.773-0.895) in the training cohort and a C-index of 0.851 and an AUC of 0.851 (95% CI: 0.753-0.949) in the validation cohort. The calibration curves also showed that the model had a medium ability to predict acute kidney disease risk. Decision curve analysis showed that the nomogram was clinically useful when interventions were decided at the possibility threshold of 22%. Conclusion: This novel prediction nomogram may allow for convenient prediction of acute kidney disease in patients with acute kidney injury, which may help to improve outcomes.

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“…En tal sentido se identificó la anemia como FR independiente de nefropatía por contraste (Mehran, et al, 2019). Otros autores describen una incidencia entre 6,2 y 26,2% (Cheng, et al, 2020).…”

Section: Discussionunclassified

“…Esta necesaria exposición implica el riesgo de reacciones adversas, de las cuales, una de las más temidas es el daño renal agudo inducido por MC, o nefropatía inducida por medios de contraste (NIC). Esta complicación, sin duda, puede empeorar el pronóstico vital y aumenta la mortalidad de los pacientes afectos (Cheng, et al, 2020).…”

Section: Introductionunclassified

Contrast-induced nephropathy associated factors in patients with significant coronary obstruction

González

Morejón

Barbeito

2021

IJMSS

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Coronary intervention is associated with the appearance of contrast-induced nephropathy. The purpose of the study was to assess the risk of developing contrast-induced nephropathy in patients with significant coronary obstruction and its relationship with known risk factors for this nephropathy. A prospective cohort study was designed with 160 patients treated at the cardiocenter of the “Hermanos Ameijeiras” hospital, Cuba, who underwent invasive coronary angiography, between January 2016 and July 2017. The average age was 61.6 ± 9 ,2 years; 70.6% were men. The personal pathological history of ischemic heart disease (85.6%) and arterial hypertension (75.6%) predominated. 75% of the cases presented a significant coronary occlusion. The frequency of contrast nephropathy was 42.5%. The factors that had an important statistical relationship with the presence of significant arterial occlusion were known ischemic heart disease (p <0.001), previous percutaneous coronary intervention (p = 0.007), creatinine after the procedure (p = 0.043) and CIN (p = 0.016) as well as the volume of contrast administered (p = 0.006). In the subgroup of patients with significant occlusion, low hematocrit (p = 0.025) and emergency percutaneous coronary intervention (p = 0.007) were the most influential factors. It is concluded that patients with significant coronary occlusion have an increased risk for the development of contrast nephropathy. The correction of those risk factors that are modifiable (such as low hematocrit) and the correct application of the hydration protocol are essential to prevent this complication.

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Post-contrast acute kidney injury in a hospitalized population: short-, mid-, and long-term outcome and risk factors for adverse events

Cited by 24 publications

References 59 publications

Acute kidney disease in hospitalized acute kidney injury patients

Acute kidney disease in hospitalized acute kidney injury patients

Diabetes Mellitus as a Risk Factor for Progression from Acute Kidney Injury to Acute Kidney Disease: A Specific Prediction Model

Contrast-induced nephropathy associated factors in patients with significant coronary obstruction

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