Acute Renal Failure After Coronary Intervention
| Autor: | Robert N. Levin, Peter A. McCullough, William W. O'Neill, Robert Wolyn, Leslie L. Rocher |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Creatinine business.industry medicine.medical_treatment Contrast-induced nephropathy Renal function General Medicine Odds ratio medicine.disease Confidence interval Surgery chemistry.chemical_compound chemistry Predictive value of tests Internal medicine medicine business Dialysis Kidney disease |
| Zdroj: | The American Journal of Medicine. 103:368-375 |
| ISSN: | 0002-9343 |
| Popis: | PURPOSE: This study set out to define the incidence, predictors, and mortality related to acute renal failure (ARF) and acute renal failure requiring dialysis (ARFD) after coronary intervention. PATIENTS AND METHODS: Derivation-validation set methods were used in 1,826 consecutive patients undergoing coronary intervention with evaluation of baseline creatinine clearance (CrCl), diabetic status, contrast exposure, postprocedure creatinine, ARF, ARFD, in-hospital mortality, and long-term survival (derivation set). Multiple logistic regression was used to derive the prior probability of ARFD in a second set of 1,869 consecutive patients (validation set). RESULTS: The incidence of ARF and ARFD was 144.6/1,000 and 7.7/1,000 cases respectively. The cutoff dose of contrast below which there was no ARFD was 100 mL. No patient with a CrCl > 47 mL/min developed ARFD. These thresholds were confirmed in the validation set. Multivariate analysis found CrCl [odds ratio (OR) = 0.83, 95% confidence interval (CI) 0.77 to 0.89, P P = 0.01), and contrast dose (OR = 1.008, 95% CI 1.002 to 1.013, P = 0.01) to be independent predictors of ARFD. Patients in the validation set who underwent dialysis had a predicted prior probability of ARFD of between 0.07 and 0.73. The in-hospital mortality for those who developed ARFD was 35.7% and the 2-year survival was 18.8%. CONCLUSION: The occurrence of ARFD after coronary intervention is rare ( |
| Databáze: | OpenAIRE |
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