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Updated: Mar 13, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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.
Insights
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.
Background:
Studies of kidney disease associated with cardiac catheterization typically rely on billing records rather than laboratory data. We examined the associations between percutaneous coronary interventions, acute kidney injury, and chronic kidney disease progression using comprehensive Veterans Affairs clinical and laboratory databases.
Methods And Results:
Patients undergoing percutaneous coronary interventions between 2005 and 2010 (N=24 405) were identified in the Veterans Affairs Clinical Assessment, Reporting, and Tracking registry and examined for associated acute kidney injury and chronic kidney disease development or progression relative to 24 405 matched population controls. Secondary outcomes analyzed included dialysis, acute myocardial infarction, and mortality. The incidence of chronic kidney disease progression following percutaneous coronary interventions complicated by acute kidney injury, following uncomplicated coronary interventions, and in matched controls were 28.66, 11.15, and 6.81 per 100 person-years, respectively. Percutaneous coronary intervention also increased the likelihood of chronic kidney disease progression in both the presence and absence of acute injury relative to controls in adjusted analyses (hazard ratio [HR], 5.02 [95% CI, 4.68-5.39]; and HR, 1.76 [95% CI, 1.70-1.86]). Among patients with estimated glomerular filtration rate <60 mL/min per 1.73 m2, acute kidney injury increased the likelihood of disease progression by 8-fold. Similar results were observed for all secondary outcomes.
Conclusions:
Acute kidney injury following percutaneous coronary intervention was associated with increased chronic kidney disease development and progression and mortality.
