| Effects of chronic kidney disease and post-angiographic acute kidney injury on long-term prognosis after coronary artery angiography. | |
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MedLine Citation:
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PMID: 20940369 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Both chronic kidney disease (CKD) and post-angiographic acute kidney injury (AKI) are regarded as risks factors for long-term mortality after coronary angiography. On the other hand, acute haemodynamic disturbances requiring haemodynamic support have a strong impact on both the incidence of AKI and on prognosis after coronary angiography. The aim of this study was to determine the impact of CKD and AKI on long-term prognosis after coronary angiography among hospital survivors and to determine relationships with haemodynamic variables. METHODS: We studied 2439 patients who underwent coronary angiography or percutaneous coronary intervention. Relationships between both CKD and AKI and mortality or cardiovascular diseases were measured using unadjusted and adjusted Cox models for case-mix and laboratory variables. RESULTS: Multivariable Cox regression analysis identified CKD as an independent predictor of long-term mortality [adjusted hazard ratio (AHR) 1.51; 95% confidence interval (95% CI) 1.07-2.13] and composite end points (AHR 1.72; 95% CI 1.40-2.11). Lower estimated glomerular filtration ratio levels below 50 mL/min/1.73 m(2) were significantly associated with mortality after adjustments. A similar association was found even in haemodynamically stable patients. AKI was also a predictor of long-term composite end points (AHR 1.64; 95% CI 1.09-2.46); however, its impact was attenuated in haemodynamically stable patients. CONCLUSIONS: Among hospital survivors, CKD is an independent predictor for both long-term mortality and composite end points, regardless of haemodynamic conditions. AKI is also a predictor of long-term prognosis; however, its impact may be attenuated in haemodynamically stable hospital survivors. |
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Authors:
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Tomonori Kimura; Yoshitsugu Obi; Keiko Yasuda; Ko-Ichi Sasaki; Yoshihiro Takeda; Yoshiyuki Nagai; Enyu Imai; Hiromi Rakugi; Yoshitaka Isaka; Terumasa Hayashi |
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Publication Detail:
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Type: Journal Article Date: 2010-10-12 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 26 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-06-06 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 1838-46 Citation Subset: IM |
Affiliation:
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Correspondence and offprint requests to: Terumasa Hayashi: t-hayashi@rgmc.izumisano.osaka.jp. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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