[Estimation of renal function in patients with normal serum creatinine undergoing primary percutaneous coronary intervention].
Kidney disease and cardiovascular disease seem to be lethally synergistic and both approach level of epidemy. On the other hand, patients with ischemic heart disease often exhibit renal dysfunction due to concomitant diabetes, hypertension, congestive heart failure and dyslipidemia. Patients with chronic kidney disease are at increased risk of death after acute MI.


OBJECTIVE
Assessment of prevalence of kidney dysfunction in patients with normal serum creatinine using estimated GFR in a cohort of 922 consecutive patients undergoing primary PCI due to acute myocardial infarction.


RESULTS
Normal serum creatinine (less than 1.5 mg/dL in males and less than 1.2 mg/dL in females) was observed in 857 (93%) patients. Mean GFR was 69.0 +/- 21.15 ml/min (Cockcroft-Gault formula), 85.18 +/- 24.17 ml/min (MDRD) or 72.25 +/- 21.65 ml/min (Jeliffe). According to Cockcroft-Gault formula stage 2 chronic kidney disease-CKD i.e. GFR 60-89 ml/min was found in 378 patients (44.11%) and stage 3 CKD i.e. GFR 30-59 ml/min was found in 283 (33.02%) patients with normal serum creatinine. According to MDRD formula stage 2 CKD was found in 440 patients (51.32%) and stage 3 CKD was found in 71 (8.29%) patients, whereas according to Jeliffe formula stage 2 CKD was found in 405 patients (47.25%) and stage 3 CKD was found in 194 (22.63%) patients with normal serum creatinine.


CONCLUSIONS
The prevalence of chronic kidney disease is high, up to almost 80% patients undergoing primary PCI despite normal serum creatinine. The risk of contrast nephropathy with worse outcomes is enhanced in these patients. In patients with risk factors for cardiovascular disease, GFR should be estimated since renal dysfunction is one more important risk for cardiovascular morbidity and mortality.
Bachórzewska-Gajewska
Hanna
H
Zakład Kardiologii Inwazyjnej AM w Białymstoku. hgajewska@op.pl
Małyszko
Jolanta
J
Małyszko
Jacek
J
Kralisz
Paweł
P
Poniatowski
Bogusław
B
Musiał
Włodzimierz
W
Dobrzycki
Sławomir
S
D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology*; D007677:Kidney Function Tests; D008297:Male; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome
D015415:Biomarkers; D003404:Creatinine