![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
Abstract
Purpose
The estimated glomerular filtration rate (eGFR) based on creatinine is crucial for the risk assessment of contrast-associated acute kidney injury (CA-AKI). In recent, the difference between cystatin C-based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcr) has been widely documented. We aimed to explore whether intraindividual differences between eGFRcys and eGFRcr had potential value for CA-AKI risk assessment in patients undergoing elective percutaneous coronary intervention (PCI).
Patients and Methods
From January 2012 to December 2018, we retrospectively observed 5049 patients receiving elective PCI. To determine eGFR, serum creatinine and cystatin C levels were measured. CA-AKI was defined as serum creatinine being increased ≥ 50% or 0.3 mg/dL within 48 h after contrast agents exposure. Chronic kidney disease (CKD) was defined as the eGFR < 60 mL/min/1.73 m2.
Results
Approximately half of the participants (2479, 49.1%) had a baseline eGFRdiff (eGFRcys-eGFRcr) between −15 and 15 mL/min/1.73 m2. Restricted cubic splines analysis revealed a nonlinear relationship between eGFRdiff and CA-AKI. Multivariable logistic regression analysis indicated that compared with the reference group (−15 to 15 mL/min/1.73 m2), the negative-eGFRdiff group (less than −15 mL/min/1.73 m2) had a higher risk of CA-AKI (OR, 3.44; 95% CI, 2.57–4.64). Furthermore, patients were divided into four groups based on CKD identified by eGFRcys or eGFRcr. Multivariable logistic analysis revealed that patients with either CKDcys (OR, 2.94; 95% CI, 2.19–3.95, P < 0.001) or CKDcr (OR, 2.44; 95% CI, 1.19–4.63, P < 0.001) had an elevated risk of CA-AKI compared to those without CKDcys and CKDcr.
Conclusion
There are frequent intraindividual differences between eGFRcys and eGFRcr, and these differences can be used to forecast the risk of CA-AKI.
Abbreviations
PCI, percutaneous coronary intervention; CA-AKI, contrast-associated acute kidney injury; eGFRcr, creatinine-based eGFR; eGFR, estimated glomerular filtration rate; eGFRcys, cystatin C-based eGFR; CM, contrast medium; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration; MDRD, Modification of Diet in Renal Disease.
Data Sharing Statement
The datasets generated during the current study are available from the corresponding author on reasonable request.
Ethics Approval and Informed Consent
A review and approval of the study were performed by the Fujian Provincial Hospital Ethics Committee (Ethical approval number: K2019-07-011). Our research conformed to the Declaration of Helsinki. Due to the retrospective nature of the study, informed written consent was waived. Personal information and data remained confidential and anonymous.
Author Contributions
LW Z, MQ L and JL Z contributed equally to this work. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.