对比剂相关急性肾损伤(CA-AKI)是冠状动脉造影(CAG)后常见的并发症。然而,围绕其精确定义一直存在争议。尽管以前的研究已经证明了适当的定义在管理高风险CA-AKI患者中的成功应用,关于不同定义与慢性肾脏病(CKD)患者预后之间的相关性的研究仍然有限.
■本研究共纳入4197例接受冠状动脉造影(CAG)的CKD患者。使用对比剂相关急性肾损伤(CA-AKI)的两个定义:CA-AKIA,这被定义为在CAG后72小时内血清肌酐(SCr)从基线增加≥0.5mg/dL或>25%,和CA-AKIB,定义为CAG后48小时内SCr从基线增加≥0.3mg/dL或>50%。Cox回归分析用于评估这两种定义与长期死亡率之间的关联。此外,计算人群归因危险度(PAR),以评估CA-AKI定义对长期预后的影响.
■在4.70(2.50-7.78)年的中位随访期内,总的长期死亡率为23.6%,根据CA-AKIA和CA-AKIB标准,CA-AKI患者的长期死亡率分别为33.5%和33.8%,分别。我们发现CA-AKIA(HR:1.45,95%CI:1.23-1.70,p<0.001)和CA-AKIB(HR:1.44,95%CI:1.23-1.69,p<0.001)与长期死亡率相关。CA-AKIA的PAR最高(5.87%),其次是CA-AKIB(5.70%)。
对比剂相关急性肾损伤(CA-AKI)是CKD患者冠状动脉造影(CAG)中常见的并发症,CA-AKI的两种定义均与不良长期预后显著相关.因此,在CKD患者的临床管理中,至关重要的是优先考虑CA-AKI,无论使用的具体CA-AKI定义如何。
UNASSIGNED: Contrast-associated acute kidney injury (CA-AKI) is a prevalent complication following coronary angiography (CAG). However, there is ongoing controversy surrounding its precise definition. Although previous studies have demonstrated the successful application of appropriate
definitions in managing high-risk CA-AKI patients, there remains limited research on the association between different
definitions and prognosis specifically in patients with chronic kidney disease (CKD).
UNASSIGNED: A total of 4197 CKD patients undergoing coronary angiography (CAG) were included in this study. Two
definitions of contrast-associated acute kidney injury (CA-AKI) were used: CA-AKIA, which was defined as an increase of ≥0.5 mg/dL or >25% in serum creatinine (SCr) from baseline within 72 hours after CAG, and CA-AKIB, which was defined as an increase of ≥0.3 mg/dL or >50% in SCr from baseline within 48 hours after CAG. Cox regression analysis was employed to assess the association between these two
definitions and long-term mortality. Additionally, population attributable risks (PARs) were calculated to evaluate the impact of CA-AKI
definitions on long-term prognosis.
UNASSIGNED: During the median follow-up period of 4.70 (2.50-7.78) years, the overall long-term mortality was 23.6%, and the long-term mortality in patients with CA-AKI according to both CA-AKIA and CA-AKIB criteria were 33.5% and 33.8%, respectively. We found that CA-AKIA (HR: 1.45, 95% CI: 1.23-1.70, p<0.001) and CA-AKIB (HR: 1.44, 95% CI: 1.23-1.69, p<0.001) were associated with long-term mortality. The PARs were the highest for CA-AKIA (5.87%), followed by CA-AKIB (5.70%).
UNASSIGNED: Contrast-associated acute kidney injury (CA-AKI) is a frequently observed complication in CKD patients undergoing coronary angiography (CAG), and both definitions of CA-AKI are significantly correlated with a poor long-term prognosis. Consequently, in the clinical management of CKD patients, it is crucial to prioritize CA-AKI, irrespective of the specific CA-AKI definition used.