부산대학교 도서관

Background:Contrast-induced acute kidney injury (CI-AKI) is an independent predictor of mortality after angiography and percutaneous interventions. Proteinuria is an indicator of glomerular or proximal renal tubular damage. Association of proteinuria and CI-AKI is not well established. We studied proteinuria as a predictor of CI-AKI in patients undergoing coronary angiography.Methods:All patients who underwent coronary angiography in a tertiary care medical center in the United States, with or without percutaneous coronary intervention from January 2012 to December 2016, who had a baseline routine urine analysis and a pre and post procedure basic metabolic panel were included in the study. CI-AKI was defined as an increase of ?0.3 mg/dL in creatinine within 72 hours of administration of contrast. Patients were divided into two groups based on the presence or absence of proteinuria. The incidence of CI-AKI between the two groups was compared. Crude and adjusted odds ratio (AOR) were obtained using univariate logistic regression analysis.Results:Out of 918 patients (females= 33.3%, mean age 57.7 ? 11.4 years) who were included in the final analysis, 152 (16.6%) developed CI-AKI. Proteinuria, hypertension, prior heart failure, chronic kidney disease, and intra-aortic balloon pump (IABP) use were identified as independent predictors of CI-AKI. Proteinuria was significantly associated with increased risk of developing CI-AKI [ AOR = 1.5, 95% confidence interval (CI) = 1.2 - 2.3, p = 0.01] adjusted for all other significant predictors of CI-AKI.Conclusion:Proteinuria is an independent predictor of CI-AKI in patients undergoing coronary angiography with or without PCI