贫血对冠心病患者冠状动脉介入治疗术后急性造影剂肾损伤的影响(英文)  

Impact of anemia on development of contrast-induced acute kidney injury in patients undergoing percutaneous coronary interventions

作　　者：李文华 李东野 徐通达 朱红 张延斌 

机构地区：[1]Department of Cardiology,Affiliated Hospital of Xuzhou Medical College

出　　处：《中华临床医师杂志（电子版）》2011年第20期6033-6038,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：Objective The aim of the present study was to assess the influence of anemia on development of contrast-induced acute kidney injury (AKI) after percutaneous coronary intervention.Methods The subject group consisted of 1026 patients who had undergone coronary intervention procedure between January 1,2008 and October 31,2009.A nonionic,low osmolality contrast agent was used in our laboratory at this time.Serum creatinine values were measured before and within 48 h of administration of contrast agents.Contrast-induced nephropathy was defined as an increase of 0.5 mg/dl or 25% in serum creatinine concentration over baseline within 48 h of angiography,anemia as hemoglobin (Hb) <120 g/L in women and <130 g/L in men.Results Among the 1026 patients studied,32(3.1%) experienced AKI after procedure.AKI occurred in 6.3% of the anemic patients and 2.2% of the non-anemic patients (P<0.01).The incidence of AKI increased with decreasing of baseline estimated glomerular filtration rate (eGFR)in both the anemia and non-anemia groups.In patients with baseline eGFR<30 ml·min-1·(1.73 m2)-1,a high proportion of both anemic and non-anemic patients experienced (24.6% vs.18.5%).When baseline eGFR was 30-59 ml·min-1·(1.73 m2)-1,the incidence of in anemic patients was 2-fold higher than in non-anemic patients (7.9% vs.3.8%;P<0.05).The amount of the contrast agent administered was similar for AKI and non-AKI patients [(182±46)ml vs.(176±48) ml,P>0.05) ].Multivariate Logistic regression analysis found that baseline eGFR and baseline hemoglobin were independent predictors of AKI.When presence of anemia was introduced into the multivariate model instead of baseline hemoglobin,it was also showed a significant association with AKI.Conclusions Anemia increases the incidence of AKI in patients with moderate renal dysfunction.Patients with both preexisting renal insufficiency and anemia are at high risk of AKI.Baseline eGFR and baseline hemoglobin (or anemia) are independent predictors of AKI.Objective The aim of the present study was to assess the influence of anemia on development of contrast-induced acute kidney injury (AKI) after percutaneous coronary intervention.Methods The subject group consisted of 1026 patients who had undergone coronary intervention procedure between January 1,2008 and October 31,2009.A nonionic,low osmolality contrast agent was used in our laboratory at this time.Serum creatinine values were measured before and within 48 h of administration of contrast agents.Contrast-induced nephropathy was defined as an increase of 0.5 mg/dl or 25% in serum creatinine concentration over baseline within 48 h of angiography,anemia as hemoglobin (Hb) <120 g/L in women and <130 g/L in men.Results Among the 1026 patients studied,32(3.1%) experienced AKI after procedure.AKI occurred in 6.3% of the anemic patients and 2.2% of the non-anemic patients (P<0.01).The incidence of AKI increased with decreasing of baseline estimated glomerular filtration rate (eGFR)in both the anemia and non-anemia groups.In patients with baseline eGFR<30 ml·min-1·(1.73 m2)-1,a high proportion of both anemic and non-anemic patients experienced (24.6% vs.18.5%).When baseline eGFR was 30-59 ml·min-1·(1.73 m2)-1,the incidence of in anemic patients was 2-fold higher than in non-anemic patients (7.9% vs.3.8%;P<0.05).The amount of the contrast agent administered was similar for AKI and non-AKI patients [(182±46)ml vs.(176±48) ml,P>0.05) ].Multivariate Logistic regression analysis found that baseline eGFR and baseline hemoglobin were independent predictors of AKI.When presence of anemia was introduced into the multivariate model instead of baseline hemoglobin,it was also showed a significant association with AKI.Conclusions Anemia increases the incidence of AKI in patients with moderate renal dysfunction.Patients with both preexisting renal insufficiency and anemia are at high risk of AKI.Baseline eGFR and baseline hemoglobin (or anemia) are independent predictors of AKI.

关 键 词：ANEMIA NEPHROSIS Contrast agents ANGIOPLASTY 

分 类 号：R541.4[医药卫生—心血管疾病]