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[Estimation of renal function in patients with normal serum creatinine undergoing primary percutaneous coronary

Hanna Bachórzewska-Gajewska1, Jolanta Małyszko, Jacek Małyszko

  • 1Zakład Kardiologii Inwazyjnej AM w Białymstoku. hgajewska@op.pl

Polskie Archiwum Medycyny Wewnetrznej
|February 6, 2007
PubMed

Insights

Nearly 80% of patients undergoing primary percutaneous coronary intervention (PCI) have chronic kidney disease (CKD), even with normal serum creatinine. Estimating glomerular filtration rate (GFR) is crucial for assessing cardiovascular risk in these patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Context:

  • Cardiovascular disease and kidney disease share a synergistic, epidemic relationship.
  • Patients with ischemic heart disease often have renal dysfunction due to comorbidities like diabetes and hypertension.
  • Chronic kidney disease (CKD) increases the risk of mortality following acute myocardial infarction (MI).

Purpose:

  • To assess the prevalence of kidney dysfunction in patients with normal serum creatinine undergoing primary PCI for acute MI.
  • To evaluate kidney function using estimated glomerular filtration rate (eGFR) in this patient cohort.

Summary:

  • A study of 922 patients undergoing primary PCI found that 93% had normal serum creatinine.
  • However, using various eGFR formulas (Cockcroft-Gault, MDRD, Jeliffe), a significant prevalence of CKD (Stage 2 or 3) was observed, ranging from 33% to nearly 80% in patients with normal creatinine.
  • This highlights the limitations of serum creatinine in detecting renal impairment in this population.

Impact:

  • The high prevalence of undiagnosed CKD in patients undergoing primary PCI poses an increased risk for contrast nephropathy and adverse outcomes.
  • Estimating GFR is essential for identifying renal dysfunction, a significant risk factor for cardiovascular morbidity and mortality.
  • This underscores the importance of comprehensive risk assessment in patients with cardiovascular disease risk factors.
Abstract

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