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Updated: Jan 23, 2026
Direct Drug Delivery to Kidney via the Renal Artery
Published on: April 17, 2021
Cardiovascular and renal outcomes following percutaneous coronary intervention in a population with renal disease: a
Insights
Percutaneous coronary intervention (PCI) in patients with chronic kidney disease (CKD) was associated with lower mortality and did not worsen renal function. PCI is a viable treatment option for CKD patients, with serum creatinine and calcium-phosphate product predicting outcomes.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Patients with chronic kidney disease (CKD) often avoid percutaneous coronary intervention (PCI) due to perceived poor outcomes.
- This study addresses the outcomes of PCI in CKD patients.
Purpose of the Study:
- To compare outcomes following PCI in individuals with CKD versus matched controls without PCI.
- To identify factors predicting poor outcomes after PCI in CKD patients.
Main Methods:
- Retrospective observational case-control study of 144 CKD patients undergoing PCI and 144 matched controls.
- Kaplan-Meier curves and Cox regression analyzed mortality; Wilcoxon Rank testing assessed renal function changes.
- Logistic regression explored predictors of mortality, including biochemical and hematological measures.
Main Results:
- PCI patients had significantly lower mortality compared to controls (HR 0.46).
- PCI did not significantly alter renal function (P=0.52).
- Elevated serum creatinine and calcium-phosphate product predicted mortality post-PCI in CKD patients.
Conclusions:
- PCI in CKD patients is linked to reduced mortality and does not accelerate CKD progression.
- PCI should be considered a treatment option for CKD patients.
- Serum creatinine and calcium-phosphate product can aid in risk stratification for CKD patients undergoing PCI.
Background:
Patients with renal disease are less likely to undergo percutaneous coronary intervention (PCI) due to concerns about poor outcomes.
Aim:
We describe outcomes following PCI in individuals with chronic kidney disease (CKD), as compared with matched controls with comparable CKD who did not undergo PCI. We also identified factors predictive of poor outcomes following PCI amongst patients with CKD.
Design:
Retrospective observational case-control study.
Methods:
Cases were individuals with CKD (stages 1-5) undergoing PCI between 2008 and 2014. Controls were age, gender and creatinine-matched individuals not requiring PCI. We compared mortality between groups using Kaplan-Meier curves and Cox regression modelling. We assessed changes in serum creatinine using Wilcoxon Rank testing. We explored the relationship between biochemical and haematological measures (baseline creatinine, calcium, phosphate, calcium-phosphate product, parathyroid hormone, white cell count, haemoglobin, platelet count, c-reactive protein and total cholesterol) and post-PCI mortality, using logistic regression.
Results:
We identified 144 cases and 144 controls. Mortality was significantly lower amongst cases compared with controls [hazard ratio 0.46 (95% confidence intervals 0.31, 0.69)]. PCI did not result in a significant change in renal function (P=0.52). Amongst cases, serum creatinine and calcium-phosphate product were predictors of mortality following PCI.
Conclusion:
Cases undergoing PCI had lower mortality, and PCI was not associated with accelerated CKD progression. On this data, PCI should not be deferred as a treatment option in patients with CKD. Serum creatinine and calcium-phosphate product predict mortality following PCI in this cohort, and may be useful in risk-stratifying patients with CKD being considered for PCI.
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