title: Pre-procedural glucose levels and the risk for contrast-induced acute kidney injury in patients undergoing emergency coronary intervention.
abstract: BACKGROUND
  The incidence, risk factors, and outcome of contrast-induced acute kidney injury (CI-AKI) in 730 patients with acute coronary syndrome (ACS) undergoing emergency percutaneous coronary intervention (PCI), whose contrast volume was below maximum allowable contrast dose (MACD) was prospectively investigated.
  
  
  RESULTS
  MACD was defined as (5ml×body weight [kg]/baseline creatinine [mg/dl]). CI-AKI was defined as a greater than 25% increase in creatinine from the baseline or an absolute increase of ≥0.5mg/dl within 48h after the procedure. CI-AKI occurred in 212 (29%) patients. Patients with CI-AKI had a higher risk for in-hospital mortality (9.4% vs. 1.5%, P<0.001) and a longer stay in the coronary care unit (median, 4.0 vs. 3.0 days, P<0.001) compared with those without CI-AKI. In a multivariate logistic analysis including 20 clinical variables, elevated glucose levels as variables categorized into quartiles were independently (P<0.001) associated with the development of CI-AKI. In addition, this relationship was seen in both the subgroup of patients with known diabetes and that of those without known diabetes.
  
  
  CONCLUSIONS
  CI-AKI might occur commonly and could be be associated with a more complicated clinical course in ACS patients undergoing emergency PCI whose contrast volume does not exceed MACD. Elevated pre-procedural glucose might be a powerful and independent risk factor for the development of CI-AKI in this population.
authors.affiliation: Department of Cardiology, Fujita Health University Hospital, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Naruse
authors.forename: Junnichi
authors.initials: J
authors.lastname: Ishii
authors.forename: Tousei
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kawai
authors.forename: Kousuke
authors.initials: K
authors.lastname: Hattori
authors.forename: Masanori
authors.initials: M
authors.lastname: Okumura
authors.forename: Sadako
authors.initials: S
authors.lastname: Motoyama
authors.forename: Shigeru
authors.initials: S
authors.lastname: Matsui
authors.forename: Ikuko
authors.initials: I
authors.lastname: Tanaka
authors.forename: Hideo
authors.initials: H
authors.lastname: Izawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Nomura
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000139:chemically induced* / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D003287:Contrast Media; D003404:Creatinine