title: Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention.
abstract: BACKGROUND
  In patients undergoing percutaneous coronary intervention (PCI) in the modern era, the incidence and prognostic implications of acute renal failure (ARF) are unknown.
  
  
  RESULTS
  With a retrospective analysis of the Mayo Clinic PCI registry, we determined the incidence of, risk factors for, and prognostic implications of ARF (defined as an increase in serum creatinine [Cr] >0.5 mg/dL from baseline) after PCI. Of 7586 patients, 254 (3.3%) experienced ARF. Among patients with baseline Cr <2.0, the risk of ARF was higher among diabetic than nondiabetic patients, whereas among those with a baseline Cr >2.0, all had a significant risk of ARF. In multivariate analysis, ARF was associated with baseline serum Cr, acute myocardial infarction, shock, and volume of contrast medium administered. Twenty-two percent of patients with ARF died during the index hospitalization compared with only 1.4% of patients without ARF (P<0.0001). After adjustment, ARF remained strongly associated with death. Among hospital survivors with ARF, 1- and 5-year estimated mortality rates were 12.1% and 44.6%, respectively, much greater than the 3.7% and 14.5% mortality rates in patients without ARF (P<0.0001).
  
  
  CONCLUSIONS
  The overall incidence of ARF after PCI is low. Diabetic patients with baseline Cr values <2.0 mg/dL are at higher risk than nondiabetic patients, whereas all patients with a serum Cr >2.0 are at high risk for ARF. ARF was highly correlated with death during the index hospitalization and after dismissal.
authors: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
authors: Charanjit S
authors: CS
authors: Rihal
authors: Stephen C
authors: SC
authors: Textor
authors: Diane E
authors: DE
authors: Grill
authors: Peter B
authors: PB
authors: Berger
authors: Henry H
authors: HH
authors: Ting
authors: Patricia J
authors: PJ
authors: Best
authors: Mandeep
authors: M
authors: Singh
authors: Malcolm R
authors: MR
authors: Bell
authors: Gregory W
authors: GW
authors: Barsness
authors: Verghese
authors: V
authors: Mathew
authors: Kirk N
authors: KN
authors: Garratt
authors: David R
authors: DR
authors: Holmes
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015897:Comorbidity; D003401:Creatine / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000601:surgery; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D003401:Creatine