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摘要
Preexisting renal impairment and the amount of contrast media are the most important risk factors for contrast-induced acute kidney injury (CI-AKI). We aimed to investigate whether the product of contrast medium volume and urinary albumin/creatinine ratio (CMV x UACR) would be a better predictor of CI-AKI in patients undergoing nonemergency coronary interventions. This was a prospective single-center observational study, and 912 consecutive patients who were exposed to contrast media during coronary interventions were investigated prospectively. CI-AKI is defined as a 44.2 mu mol/L rise in serum creatinine or a 25% increase, assessed within 48h after administration of contrast media in the absence of other causes. Fifty patients (5.48%) developed CI-AKI. The urinary albumin/creatinine ratio (UACR) (OR=1.002, 95% CI=1.000-1.003, p=.012) and contrast medium volume (CMV) (OR=1.008, 95% CI=1.001-1.014, p=.017) were independent risk factors for the development of CI-AKI. The area under the ROC curve of CMV, UACR and CMVxUACR were 0.662 (95% CI=0.584-0.741, p<.001), 0.761 (95% CI=0.674-0.847, p<.001) and 0.808 (95% CI=0.747-0.896, p<.001), respectively. The cutoff value of CMVxUACR to predict CI-AKI was 1186.2, with 80.0% sensitivity and 62.2% specificity. The product of CMV and UACR (CMVxUACR) might be a predictor of CI-AKI in patients undergoing nonemergency coronary interventions, which was superior to CMV or UACR alone.
