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Updated: Dec 10, 2025
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Impact of renal function on patients with acute coronary syndromes: 15,593 patient-years study
Łukasz Kuźma1, Jolanta Małyszko2, Anna Kurasz1
1Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland.
Insights
Post-contrast acute kidney injury (PC-AKI) is a significant complication in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Early detection and prevention of PC-AKI are crucial for improving long-term mortality outcomes.
Area of Science:
- Cardiology
- Nephrology
- Clinical Research
Background:
- Coexistence of chronic kidney disease (CKD) with acute coronary syndromes (ACS) leads to significantly worse patient outcomes.
- Assessing the impact of renal function on mortality in ACS patients is critical for improving clinical management.
Purpose of the Study:
- To evaluate the influence of renal function on mortality rates in patients diagnosed with acute coronary syndromes (ACS).
Main Methods:
- Retrospective analysis of 2213 patients with ACS hospitalized between 2009-2015.
- Exclusion criteria included early death, severe kidney dysfunction (eGFR <15), and current hemodialysis.
- Mean follow-up duration was 2296 days to assess long-term outcomes.
Main Results:
- Chronic kidney disease (CKD) was present in 24.1% of patients, more common in NSTEMI.
- Post-contrast acute kidney injury (PC-AKI) occurred more frequently in STEMI patients (5% vs 4.1%).
- Mortality was 31.9% overall, but 57.6% in the PC-AKI group. Increased creatinine levels and comorbidities like diabetes and atrial fibrillation were associated with higher PC-AKI risk.
Conclusions:
- Post-contrast acute kidney injury (PC-AKI) is a major complication in ACS patients, particularly those with STEMI undergoing PCI.
- PC-AKI serves as a prognostic marker for long-term mortality.
- While PC-AKI prevention and diagnosis require attention, necessary PCI should not be withheld due to fear of this complication.
Introduction:
Coexistence of chronic kidney disease (CKD) in the case of acute coronary syndromes (ACS) significantly worsens the outcomes.
Aim:
The aim of our study was to assess renal function impact on mortality among patients with ACS.
Materials And Methods:
The study was based on records of 21,985 patients hospitalized in the Medical University of Bialystok in 2009-2015. Inclusion criteria were ACS. Exclusion criteria were: death within 24 h of admission, eGFR <15 ml/min/1.73 m2, hemodialysis. Mean observation time was 2296 days.
Results:
Criteria were met by 2213 patients. CKD occurred in 24.1% (N = 533) and more often affected those with NSTEMI (26.2 (337) vs. 21.2 (196), p = .006). STEMI patients had higher incidence of post-contrast acute kidney injury (PC-AKI) (5 (46) vs. 4.1 (53), p < .001). During the study, 705 people died (31.9%), more often with NSTEMI (33.2% (428) vs. 29.95% (277), p < .001). However, from a group of patients suffering from PC-AKI 57.6% died. The risk of PC-AKI increased with creatinine concentration (RR: 2.990, 95%CI: 1.567-5.721, p < .001), occurrence of diabetes mellitus (RR: 2.143, 95%CI: 1.029-4.463, p = .042), atrial fibrillation (RR: 2.289, 95%CI: 1.056-4.959, p = .036). Risk of death was greater with an increase in postprocedural creatinine concentration (RR: 2.254, 95%CI: 1.481-3.424, p < .001).
Conclusion:
PC-AKI is a major complication in patients with ACS, occurs more frequently in STEMI and may be a prognostic marker of long-term mortality in patients undergoing percutaneous coronary intervention (PCI). More attention should be given to the prevention and diagnosis of PC-AKI but necessary PCI should not be withheld in fear of PC-AKI.
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