Microalbuminuria in patients with preserved renal function as a risk factor for contrast-Induced acute kidney injury following invasive coronary angiography

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• 作者：Haoyu Meng¹ ; Peng Wu¹ ; Yingming Zhao¹ ; Zhihui Xu ; Ze-Mu Wang ; Chunjian Li ; Liansheng Wang ; Zhijian Yang ; ^{zhijianyangnj@njmu.edu.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Microalbuminuria ; Invasive coronary angiography ; Contrast-induced acute kidney injury ; Serum creatinine ; Urine albumin to creatinine ratio
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：85
• 期：6
• 页码：1063-1067
• 全文大小：346 K

文摘

To investigate the association between pre-existing microalbuminuria among patients with preserved renal function and contrast- induced acute kidney injury (AKI) following coronary angiography.

Material and methods

612 consecutive patients with preserved renal function (eGFR ≥ 60 ml/min and without macroalbuminuria) undergoing scheduled coronary angiography were stratified into microalbuminuria group (107 patients) and normal-albuminuria group (505 patients) according to the urine albumin to creatinine ratio (ACR) levels. Microalbuminuria was defined as ACR in the range of 30–300 mg/g and normal-albuminuria was defined as ACR <30 mg/g. Contrast-induced AKI was defined as a relative increase in serum creatinine (SCr) concentration of at least 25% or an absolute increase in SCr of 44.2 μmol/L within 72 h after the procedure.

Results

The peak increases of SCr in microalbuminuria group were larger than those in normal-albuminuria group (10.6 ± 12.4 μmol/L vs. 4.8 ± 8.9 μmol/L，P < 0.001). The incidence of AKI was higher in patients with microalbuminuria than those with normal-albuminuria (12.1% vs. 5.0%, P = 0.005). Multivariate analysis revealed that there was an association between microalbuminuria and contrast-induced AKI risk after adjusting for confounders.

Conclusion

Pre-existing microalbuminuria is associated with greater risk for AKI in patients with a preserved renal function who undergo scheduled coronary angiography.