Risk factors of acute kidney injury after acute myocardial infarction

Abstract

Objectives: To study the risk factors for acute kidney injury (AKI) in-patients with acute myocardial infarction (AMI). Methods: A total of 1371 cases of adult in-patients with AMI in the First People's Hospital of Changzhou from January 2008 to December 2012 were retrospectively analyzed. Based on the occurrence of AKI diagnosed according to the 2012 KDIGO AKI criteria, they were divided into AKI group and non-AKI group and further into conservative treatment groups, coronary angiography (CAG) groups, and coronary artery bypass grafting (CABG) groups based on the timing of AKI occurrence, respectively. Related risk factors of AKI were analyzed by univariate and multivariate logistic regressions. Results: 410 (29.9%) developed AKI. Patients with AKI had significantly increased in-hospital mortality than patients without AKI. Multivariate logistic regression analysis showed that decreased baseline eGFR, increased fasting plasma glucose (FPG), use of diuretics and Killip grade IV were independent risk factors of AKI, while increased DBP on admission was a protective factor for patients in conservative treatment group. Decreased baseline eGFR, increased FPG, use of diuretics, intraoperative hypotension and acute infection were independent risk factors of AKI for patients in the CAG group. Decreased baseline eGFR, increased FPG, use of diuretics and low cardiac output syndrome after operation were independent risk factors of AKI for patients in the CABG group. Conclusions: AKI is a common complication and associated with increased mortality after AMI. Decreased baseline renal function, increased FPG and use of diuretics were common independent risk factors of AKI after AMI. ARTICLE HISTORY

Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus

“…The etiologies attributed to the development of AKI in the setting of ACS are diverse and include contrast-induced AKI (CI-AKI) following coronary angiography and especially PCI, hemodynamic instability with compromised renal perfusion (i.e., cardiogenic shock, mechanical complication, or arrhythmias), volume status changes, medications (e.g., nitroglycerine, diuretics, ACE I/ARBs), atheroembolism during PCI, ischemia driven alteration in the function and structure of epithelial cells, non-cardiovascular complications such as infections or inflammatory states as well as patient-associated comorbidity and predispos-ing risk factors (prior chronic kidney disease, diabetes, increased age, etc.) [24][25][26][27][28][29][30][31]. CI-AKI is a prominent and widely investigated mechanism for AKI in ACS patients following coronary angiography/PCI.…”

Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients

“…A burst of immunological and inflammatory activation were the potential causes of further renal injury [12]. Several studies proposed certain risk factors for AKI secondary to AMI, including advanced age [6, 13, 14], admission hyperglycemia [15, 16], impaired renal function at presentation [5, 6, 13], and prolonged duration to coronary reperfusion [17]. There were some prediction scores of AKI after the percutaneous coronary intervention (PCI) for AMI [18–21].…”

Assessing the influence of acute kidney injury on the mortality in patients with acute myocardial infarction: a clinical trail

“…The prevalence of AKI, elevated with the decreased LVEF, can be explained by a dramatic decrease in cardiac output after AMI, resulting in a decrease in renal perfusion, as well as the activation of renin angiotensin–aldosterone system (RAS) and cascade actions. Our prophase research also found lower LVEF levels in AKI patients [55 (48, 61) vs. 58 (51, 62), p < .001], but multivariate regression equation did not suggest an independently association with AKI [ 40 ]. In this study, LVEF was not even an independent factor for mortality among AMI patients.…”