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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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Timing of AKI after urgent percutaneous coronary intervention and clinical outcomes: a high-dimensional propensity

Alan S Go1,2,3,4, Thida C Tan5, Rishi V Parikh5

  • 1Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94549, USA. Alan.S.Go@kp.org.

BMC Nephrology
|September 6, 2021
PubMed

Insights

Acute kidney injury (AKI) after urgent percutaneous coronary intervention (PCI) is linked to worse outcomes. Early AKI (within 12-24 hours) significantly increases the risk of death and worsening kidney function.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Research

Background:

  • Acute kidney injury (AKI) is a frequent complication following percutaneous coronary intervention (PCI).
  • AKI after PCI is associated with increased mortality and progression to chronic kidney disease.
  • The prognostic value of AKI timing post-urgent PCI for risk stratification remains unclear.

Purpose of the Study:

  • To investigate the association between the timing of AKI development after urgent PCI and subsequent risks of adverse outcomes.
  • To determine if AKI timing can improve patient risk stratification following urgent PCI.

Main Methods:

  • Retrospective cohort study of adults undergoing urgent PCI between 2008-2013.
  • AKI assessed at 12, 24, and 48 hours post-PCI.
  • Multivariable Cox models with high-dimensional propensity score adjustment for mortality and worsening kidney function.

Main Results:

  • 4.2% of 7250 patients developed AKI.
  • AKI at 12 or 24 hours post-PCI was independently associated with significantly higher risks of death and worsening kidney function.
  • AKI at 48 hours was associated with increased mortality but not significantly with worsening kidney function.

Conclusions:

  • The timing of AKI after urgent PCI may differentially impact the risk of worsening kidney function.
  • Early AKI (12-24 hours) poses a greater risk for adverse kidney outcomes compared to later AKI.
  • AKI timing may offer a refined approach to risk stratification in patients undergoing urgent PCI.
Abstract

Keywords:
Acute kidney injuryChronic kidney diseaseDeathPercutaneous coronary interventionTiming

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