Cargando…

Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study

OBJECTIVES: To establish a nomogram for contrast-induced acute kidney injury (CI-AKI) risk assessment among patients with chronic kidney disease (CKD) undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). DESIGN: Prospective observational cohort study. SETTING: Southern...

Descripción completa

Detalles Bibliográficos
Autores principales: Lei, Li, Xue, Yan, Guo, Zhaodong, Liu, Bowen, He, Yibo, Liu, Jin, Nie, Zhiqiang, Chen, Liling, Chen, Kaihong, Huang, Zhidong, Liang, Min, Chen, Shiqun, Liu, Yong, Chen, Jiyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7259871/
https://www.ncbi.nlm.nih.gov/pubmed/32461299
http://dx.doi.org/10.1136/bmjopen-2020-037256
_version_ 1783540219560067072
author Lei, Li
Xue, Yan
Guo, Zhaodong
Liu, Bowen
He, Yibo
Liu, Jin
Nie, Zhiqiang
Chen, Liling
Chen, Kaihong
Huang, Zhidong
Liang, Min
Chen, Shiqun
Liu, Yong
Chen, Jiyan
author_facet Lei, Li
Xue, Yan
Guo, Zhaodong
Liu, Bowen
He, Yibo
Liu, Jin
Nie, Zhiqiang
Chen, Liling
Chen, Kaihong
Huang, Zhidong
Liang, Min
Chen, Shiqun
Liu, Yong
Chen, Jiyan
author_sort Lei, Li
collection PubMed
description OBJECTIVES: To establish a nomogram for contrast-induced acute kidney injury (CI-AKI) risk assessment among patients with chronic kidney disease (CKD) undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). DESIGN: Prospective observational cohort study. SETTING: Southern China. INTERVENTIONS: None. PARTICIPANTS: 643 consecutive patients with CKD (defined as estimated glomerular filtration rate calculated by Modification of Diet in Renal Disease formula <60 mL/min/1.73 mm(2)) were enrolled. OUTCOME MEASURES: The end point was CI-AKI defined as serum creatinine elevation ≥0.5 mg/dL or 25% from baseline within the first 48–72 hours following contrast exposure. Predictors of CI-AKI were selected by multivariable logistic regression and stepwise approach. A nomogram based on these predictors was constructed and compared with the classic Mehran Score. For validation, a bootstrap method (1000 times) was performed. RESULTS: The nomogram including age, weight, heart rate, hypotension, PCI and β-blocker demonstrated a better predictive value than the classic Mehran Score (area under the curve: 0.78 vs 0.71, p=0.024), as well as a well-fitted calibration curve (χ(2)=12.146, p=0.145). Validation through the bootstrap method (1000 times) also indicated a good discriminative power (adjusted C-statistic: 0.76). CONCLUSIONS: With fewer predictors and higher discriminative power, the present nomogram may be a simple and reliable tool to identify patients with CKD at risk of CI-AKI, whereas further external validations are needed.
format Online
Article
Text
id pubmed-7259871
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-72598712020-06-09 Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study Lei, Li Xue, Yan Guo, Zhaodong Liu, Bowen He, Yibo Liu, Jin Nie, Zhiqiang Chen, Liling Chen, Kaihong Huang, Zhidong Liang, Min Chen, Shiqun Liu, Yong Chen, Jiyan BMJ Open Cardiovascular Medicine OBJECTIVES: To establish a nomogram for contrast-induced acute kidney injury (CI-AKI) risk assessment among patients with chronic kidney disease (CKD) undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). DESIGN: Prospective observational cohort study. SETTING: Southern China. INTERVENTIONS: None. PARTICIPANTS: 643 consecutive patients with CKD (defined as estimated glomerular filtration rate calculated by Modification of Diet in Renal Disease formula <60 mL/min/1.73 mm(2)) were enrolled. OUTCOME MEASURES: The end point was CI-AKI defined as serum creatinine elevation ≥0.5 mg/dL or 25% from baseline within the first 48–72 hours following contrast exposure. Predictors of CI-AKI were selected by multivariable logistic regression and stepwise approach. A nomogram based on these predictors was constructed and compared with the classic Mehran Score. For validation, a bootstrap method (1000 times) was performed. RESULTS: The nomogram including age, weight, heart rate, hypotension, PCI and β-blocker demonstrated a better predictive value than the classic Mehran Score (area under the curve: 0.78 vs 0.71, p=0.024), as well as a well-fitted calibration curve (χ(2)=12.146, p=0.145). Validation through the bootstrap method (1000 times) also indicated a good discriminative power (adjusted C-statistic: 0.76). CONCLUSIONS: With fewer predictors and higher discriminative power, the present nomogram may be a simple and reliable tool to identify patients with CKD at risk of CI-AKI, whereas further external validations are needed. BMJ Publishing Group 2020-05-26 /pmc/articles/PMC7259871/ /pubmed/32461299 http://dx.doi.org/10.1136/bmjopen-2020-037256 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Cardiovascular Medicine
Lei, Li
Xue, Yan
Guo, Zhaodong
Liu, Bowen
He, Yibo
Liu, Jin
Nie, Zhiqiang
Chen, Liling
Chen, Kaihong
Huang, Zhidong
Liang, Min
Chen, Shiqun
Liu, Yong
Chen, Jiyan
Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study
title Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study
title_full Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study
title_fullStr Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study
title_full_unstemmed Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study
title_short Nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in China: a cohort study
title_sort nomogram for contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary angiography in china: a cohort study
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7259871/
https://www.ncbi.nlm.nih.gov/pubmed/32461299
http://dx.doi.org/10.1136/bmjopen-2020-037256
work_keys_str_mv AT leili nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT xueyan nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT guozhaodong nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT liubowen nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT heyibo nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT liujin nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT niezhiqiang nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT chenliling nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT chenkaihong nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT huangzhidong nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT liangmin nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT chenshiqun nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT liuyong nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy
AT chenjiyan nomogramforcontrastinducedacutekidneyinjuryinpatientswithchronickidneydiseaseundergoingcoronaryangiographyinchinaacohortstudy