The Value of Adding Red Cell Distribution Width to Mehran Risk Score to Predict Contrast-induced Acute Kidney Injury in Patients with Acute Coronary Syndrome

Abstract

Background: Contrast-induced acute kidney injury (CI-AKI) is a relatively reversible cause of acute kidney injury (AKI) that occurs after radiocontrast media administration. It is a common complication after percutaneous coronary intervention, especially in patients with acute coronary syndrome (ACS). The aim of this study is to determine the utility of red cell distribution width (RDW) in predicting CI-AKI in patients with ACS and to determine the value of adding RDW to the Mehran risk score (MRS) on admission.Methods: A total of 161 patients who presented with ST-elevation myocardial infarction (STEMI) or non-STEMI were identified retrospectively between January 2015 and December 2016. Patients were divided into two groups, those who developed CI-AKI after percutaneous coronary intervention (PCI) and those who did not.Results: A total of 161 patients were analyzed. Of them, 12 developed CI-AKI (eight presented with STEMI and four presented with non-STEMI). RDW did not correlate with the development of CI-AKI (14.55 ± 1.48 vs 14.83 ± 1.21; p = 0.072). The areas under the receiver operating characteristic curves (ROCs) for RDW, MRS, and the combined model (MRS and RDW) for the prediction of CI-AKI were 0.721 (95% confidence interval (CI), 0.645 to 0.788; p=0.0024), 0.885 (95% CI, 0.825 to 0.930; p<0.0001), 0.890 (95% CI, 0.831 to 0.933; p<0.0001), respectively. Pairwise comparisons between ROCs for MRS vs the combined model yielded a non-significant p-value of 0.49. This signifies no added benefit for RDW to MRS for predicting CI-AKI.Conclusion: RDW does not correlate with the development of CI-AKI in patients with ACS. The Mehran risk score remains a better indicator of CI-AKI risk assessment with no role for the addition of RDW to it. Further studies are needed to better assess predictors of CI-AKI in patients undergoing percutaneous coronary intervention.

Inflammatory Indicators and Hematological Indices in Contrast-Induced Nephropathy Among Patients Receiving Coronary Intervention: A Systematic Review and Meta-Analysis

“…According to the inclusion criteria established for the present study, an additional 58 articles were excluded. We thus finally selected 26 studies, 18–43 which consisted of a cohort of 29 454 patients receiving coronary intervention (Figure 1).…”

Prognostic value of Red Blood Cell Distribution Width in Acute Kidney Injury Patients: A Systematic Review and Meta-analysis

“…included 1251 cases and 1663 controls were identified meeting the criteria for inclusion in our meta-analysis, with publication years ranging from 2015 to 2018 [21,[26][27][28][29][30][31].…”

“…The key features of 8 studies on the association between RDW and AKI are shown in Table 1. In those studies, half of which including Caucasian descents (3 published papers included 4 RCSs) [21,26,27] and the other half of which including Asian descents [28][29][30][31]. All the included studies were prospective cohort studies, and the mean age years of the patient with AKI range from 6.7 to 68.9.…”

Inflammatory Indicator and Hematological Indices in Contrast Induced Nephropathy among Patients Receiving Coronary Intervention: A Systematic Review and Meta-Analysis

“…All of the 26 selected studies assessed the association analysis between preangiography CRP/hs-CRP, hematological indices and CIN, 13 of them contained the relationship between CIN and CRP/hs-CRP(19, 23, 24, 27, 28, 32, 34-36, 38, 39, 41, 43), while 5 of them reported NLR(25,36,38,39,42), 4 explored PLR(19,26,36,42), 5 RDW(29,30,40,41,44) and 7 HCT…”