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Age, estimated glomerular filtration rate and ejection fraction score predicts contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease: insight from the TRACK-D study

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文摘 Background The occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality.The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml?min~(-1)?1.73 m~(-2))) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD).Methods The AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography.CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium.Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles.The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis.Results The AGEF score ranged from 0.49 to 3.09.The AGEF score tertiles were defined as follows: AGEF_(low) ≤0.92 (n=1 006); 0.92 1.16 (n=992).The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEF_(low)=1.1%, AGEF_(mid)=2.3% and AGEF_(high)=5.8%, P<0.001).By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio=4.96, 95% CI: 2.32-10.58, P<0.01).ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648-0.753, P<0.001).Conclusion The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/ peripheral arterial angiography.(Clinical Trial identifier: NCT00786136).
来源 Chinese Medical Journal ,2014,127(12):2332-2336 【核心库】
DOI 10.3760/cma.j.issn.0366-6999.20133154
关键词 AGEF score ; contrast induced acute kidney injury ; diabetes ; chronic kidney disease
地址

1. Department of Cardiology, Shenyang Northern Hospital, Liaoning, Shenyang, 110016  

2. Department of Cardiology, Jinan Military 88th Hospital, Shandong, Taian, 271000  

3. Department of Cardiology, Henan Provincial People's Hospital, Henan, Zhengzhou, 450003  

4. Department of Cardiology, First Affiliated Hospital of Lanzhou University, Gansu, Lanzhou, 730000  

5. Department of Cardiology, Daping Hospital and the Research Institute of Surgery of the Third Military Medical University, Chongqing, 400038  

6. Department of Cardiology, The 306th Hospital of People's Liberation Army, Beijing, 100000

语种 英文
文献类型 研究性论文
ISSN 0366-6999
学科 临床医学;内科学
基金 supported by grants from the Key technologies R&D project of Liaoning Province ;  Key Project of National 12th Five-Year Research Program of China
文献收藏号 CSCD:5173793

参考文献 共 21 共2页

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