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Impact of Chronic Kidney Disease Severity on Clinical Outcomes After Drug-Eluting Stent Implantation: A Propensity

Hongxu Zhu1, Qi Jin1

  • 1Department of Cardiology, Beijing Haidian Hospital, Beijing, China.

Clinical Cardiology
|June 19, 2026
PubMed

Insights

Patients with moderate-to-severe chronic kidney disease (CKD) face higher risks of major adverse cardiovascular events (MACE) and kidney function decline after drug-eluting stent (DES) implantation. Early risk stratification and integrated cardiorenal care are crucial for this high-risk group.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Chronic kidney disease (CKD) is a common comorbidity in patients undergoing percutaneous coronary intervention (PCI).
  • CKD significantly increases the risk of adverse cardiovascular outcomes post-PCI.
  • The impact of moderate-to-severe CKD on outcomes after drug-eluting stent (DES) implantation requires further evaluation.

Purpose of the Study:

  • To assess the association between moderate-to-severe CKD and major adverse cardiovascular events (MACE) following DES implantation.
  • To evaluate the risk of renal function deterioration in CKD patients post-PCI with DES.
  • To determine the incidence of bleeding and contrast-associated acute kidney injury (AKI) in CKD patients.

Main Methods:

  • Retrospective cohort study of 200 patients undergoing PCI with DES implantation.
  • Patients stratified into non-CKD/mild CKD (eGFR ≥ 60 mL/min/1.73 m²) and moderate-to-severe CKD (eGFR < 60 mL/min/1.73 m²).
  • 1:1 propensity score matching used to analyze 55 pairs; MACE defined as death, MI, stroke, or repeat revascularization.

Main Results:

  • Moderate-to-severe CKD was independently associated with a 3.20-fold higher risk of MACE (HR 3.20, 95% CI 1.36-7.53; p=0.008).
  • Renal function deterioration (eGFR decline ≥ 30%) occurred more frequently in the CKD group (20.0% vs. 3.6%; p=0.028).
  • Higher rates of bleeding and contrast-associated AKI were observed in CKD patients, with AKI reaching statistical significance (p=0.030).

Conclusions:

  • Moderate-to-severe CKD independently increases MACE and renal deterioration risk after DES implantation.
  • CKD severity should be integrated into post-PCI risk stratification strategies.
  • Integrated cardiorenal monitoring and individualized management are vital for high-risk CKD patients undergoing PCI.
Abstract

Keywords:
chronic kidney diseasedrug‐eluting stentmajor adverse cardiovascular eventspercutaneous coronary interventionpropensity score matching

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