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Updated: Jun 28, 2025
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Patient characteristics associated with acute kidney injury following coronary angiography
Jonathan Knott1, Michael Engheta2, Jeffery Michel2
1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Insights
Peripheral artery disease and multivessel coronary artery disease significantly increase the risk of acute kidney injury (AKI) after coronary angiography. Patients with higher initial creatinine levels also face a greater chance of developing AKI.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Coronary angiography is a common procedure, but it carries a risk of acute kidney injury (AKI).
- Identifying patient characteristics associated with AKI is crucial for risk stratification and prevention strategies.
Purpose of the Study:
- To identify patient characteristics associated with acute kidney injury (AKI) following coronary angiography with or without percutaneous coronary intervention.
Main Methods:
- Retrospective, single-center study of 350 patients from October 1, 2017, to September 30, 2018.
- AKI defined as a creatinine rise >0.3 mg/dL within 48 hours of coronary angiography.
- Multivariable regression analysis was used to identify independent predictors of AKI.
Main Results:
- The incidence of AKI was 8.8% (41 out of 350 patients).
- Patients with AKI had higher rates of hypertension, hyperlipidemia, diabetes mellitus, and heart failure.
- Peripheral artery disease (OR=12.4), multivessel coronary artery disease (OR=11.9), and initial creatinine >1.5 mg/dL (OR=4.4) were significantly associated with increased AKI risk.
Conclusions:
- Peripheral artery disease, multivessel coronary artery disease, and elevated baseline creatinine are key risk factors for AKI post-coronary angiography.
- These findings can aid in identifying high-risk patients and implementing preventive measures.
Objective:
The objective of this study was to identify patient characteristics associated with acute kidney injury (AKI) post-coronary angiography with or without percutaneous coronary intervention.
Methods:
This retrospective, single-center study analyzed 350 patients from October 1, 2017 to September 30, 2018. The primary endpoint was AKI, defined as a rise in creatinine >0.3 mg/dL within 48 hours of coronary angiography.
Results:
AKI occurred in 41 of 350 patients (8.8%). Patients experiencing AKI had a higher incidence of hypertension (100%; P = 0.005), hyperlipidemia (98%; P = 0.001), diabetes mellitus (68%; P = 0.0005), and heart failure (37%; P = 0.0057). AKI occurred in 30 of 185 (16%) and 11 of 165 (6.7%) patients undergoing femoral and radial access, respectively. AKI incidence was not significantly affected by contrast dose (99 ± 9 vs 93 ± 3 mL; P = 0.52), fluoroscopy time (10.3 min [IQR 6.3, 17.7] vs 8.5 min [IQR 4.5, 13.9]; P = 0.2), or preprocedural computed tomography with contrast (P = 0.66). Multivariable regression showed significantly higher AKI among patients with peripheral artery disease (odds ratio [OR] = 12.4; 95% confidence interval [CI] 3.4-33.6; P = 0.0001), multivessel coronary artery disease (OR = 11.9; 95% CI 2.3-61.1; P = 0.003), and initial creatinine >1.5 mg/dL (OR = 4.4; 95% CI 1.4-13.6; P = 0.01).
Conclusion:
Peripheral artery disease, multivessel disease, and creatinine >1.5 mg/dL were associated with a higher risk of AKI in patients undergoing coronary angiography in this single-center retrospective cohort.
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