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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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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 |
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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 |
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