The Clinical Outcome of Acute Renal Failure Requiring Hemodialysis after Coronary Intervention in Patients with Chronic Kidney Disease.
- Author:
Young Hwan LIM
1
;
Hae Won JUNG
;
Yu Ji LEE
;
Na Ree KANG
;
Jung Eun LEE
;
Wooseong HUH
;
Ha Young OH
;
Yoon Goo KIM
;
Dae Joong KIM
Author Information
1. Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. daejoongsmc.kim@samsung.com
- Publication Type:Original Article
- Keywords:
Coronary angiography;
Contrast media;
Acute renal failure;
Dialysis
- MeSH:
Acute Kidney Injury;
Adult;
Contrast Media;
Coronary Angiography;
Creatinine;
Dialysis;
Diet;
Glomerular Filtration Rate;
Hospital Mortality;
Humans;
Incidence;
Medical Records;
Multivariate Analysis;
Percutaneous Coronary Intervention;
Prognosis;
Renal Dialysis;
Renal Insufficiency, Chronic;
Retrospective Studies;
Risk Factors
- From:Korean Journal of Nephrology
2008;27(3):327-332
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Acute renal failure requiring dialysis (ARFD) after coronary intervention is a rare but serious complication, and it is associated with poor prognosis. This study investigated the clinical characteristics and risk factors of ARFD after coronary intervention in patients with chronic kidney disease (CKD). METHODS: This study included 178 adult patients with CKD (baseline serum creatinine of >1.3 mg/dL) undergoing coronary intervention at Samsung Medical Center from April 2003 through June 2007. We retrospectively evaluated the incidence, clinical outcome, and risk factor of ARFD via medical records. ARFD was defined as a decrease in renal function necessitating hemodialysis in the first 7 days after percutaneous coronary intervention. The estimated glomerular filtration rate (eGFR) was obtained using the Levey Modification of Diet in Renal Disease (MDRD) formula. RESULTS: Ten of the 178 patients (5.6%) developed ARFD with a subsequent in-hospital mortality rate of 10% (n=1). According to CKD stage, incidence of ARFD was 0/136 patients (baseline eGFR 30 to 90 ml/min/1.73m2 4/32 (15 to 29,) and 7/10 (<15) respectively (0% vs 9.4% vs 70%, p<0.0001). Multivariate analysis found eGFR (OR=0.5, 95% CI 0.3 to 0.9, p=0.02) to be only independent predictor of ARFD. Of those who developed ARFD (n=10), 2 patients stopped dialysis, 8 had required permanent dialysis. CONCLUSION: Incidence of ARFD increased according to the severity of renal dysfunction. The majority of ARFD patients had required permanent dialysis.
