title: Age, estimated glomerular filtration rate and ejection fraction score predicts contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease: insight from the TRACK-D study.
abstract: BACKGROUND
  The occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml × min(-1)× 1.73 m(-2))) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD).
  
  
  METHODS
  The AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  The AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤ 0.92 (n = 1 006); 0.92 <AGEFmid ≤ 1.16 (n = 1 000), and ACEFhigh >1.16 (n = 992). The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEFlow = 1.1%, AGEFmid = 2.3% and AGEFhigh = 5.8%, P < 0.001). By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio = 4.96, 95% CI: 2.32-10.58, P < 0.01). ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648-0.753, P < 0.001).
  
  
  CONCLUSIONS
  The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography. (Clinical Trial identifier: NCT00786136).
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China.
authors.forename: Xiaozeng
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Jinan Military 88th Hospital, Taian, Shandong 271000, China.
authors.forename: Shuguang
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China.
authors.forename: Chuanyu
authors.initials: C
authors.lastname: Gao
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Lanzhou University, Lanzhou, Gansu 730000, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Daping Hospital and the Research Institute of Surgery of the Third Military Medical University, Chongqing 400038, China.
authors.forename: Chengming
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China.
authors.forename: Quanming
authors.initials: Q
authors.lastname: Jing
authors.affiliation: Department of Cardiology, The 306th Hospital of People's Liberation Army, Beijing 10000, China.
authors.forename: Shouli
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China.
authors.forename: Yingyan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China.
authors.forename: Zulu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China.
authors.forename: Yanchun
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China. Email: hanyaling@263.net.
authors.forename: Yaling
authors.initials: Y
authors.lastname: Han
mesh_terms: D058186:Acute Kidney Injury / Q000503:physiopathology*; D003287:Contrast Media; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*
chemical_list: D003287:Contrast Media