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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Chronic Kidney Disease Progression and Cardiovascular Outcomes Following Cardiac Catheterization-A
Jeremiah R Brown1, Richard J Solomon2, R Brooks Robey3
1The Dartmouth Institute for Health Policy and Clinical Practice and Section of Cardiology, Department of Medicine, Geisel School of Medicine, Lebanon, NH jbrown@dartmouth.edu.
Journal of the American Heart Association
|October 16, 2016
Summary
Percutaneous coronary intervention increases the risk of acute kidney injury and chronic kidney disease progression. This kidney injury significantly elevates the likelihood of long-term kidney disease development and mortality.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Studies on cardiac catheterization and kidney disease often use billing data, lacking laboratory validation.
- This study leverages comprehensive Veterans Affairs clinical and laboratory data for a more robust analysis.
Purpose of the Study:
- To investigate the association between percutaneous coronary interventions (PCI) and kidney disease.
- To determine the impact of PCI on acute kidney injury (AKI) and chronic kidney disease (CKD) progression.
Main Methods:
- Utilized Veterans Affairs clinical and laboratory databases for patients undergoing PCI from 2005-2010.
- Compared outcomes of 24,405 PCI patients with matched population controls.
- Analyzed secondary outcomes including dialysis, myocardial infarction, and mortality.
Main Results:
- PCI complicated by AKI showed a 28.66% incidence of CKD progression per 100 person-years.
- Uncomplicated PCI also increased CKD progression risk (11.15% vs. 6.81% in controls).
- AKI significantly heightened CKD progression risk, especially in patients with eGFR <60 mL/min/1.73 m².
Conclusions:
- Acute kidney injury following PCI is linked to increased CKD development and progression.
- PCI itself, with or without AKI, elevates the risk of CKD progression and mortality.
