[Contrast-induced acute kidney injury after primary percutaneous coronary interventions: Prevalence, predictive factors, and outcomes].
OBJECTIVE
To study the incidence, severity, predictive factors, and prognostic value of contrast-induced acute kidney injury (CIAKI) in patients with ST-segment elevation acute coronary syndrome (STSEACS), who have undergone primary percutaneous coronary intervention (PCI).


METHODS
The 2012 KDIGO criteria were used to estimate the incidence of CIAKI in 216 patients (mean age, 64 ± 13 years) admitted to Moscow City Clinical Hospital Sixty-Four and underwent primary PCI for STSEACS (hypertension in 90%, prior myocardial infarction in 27%, chronic kidney disease in 7%, type 2 diabetes mellitus in 21%). Logistic regression analysis was performed to identify predictive factors for CIAKI; following 12 months, its prognosis was assessed by phone.


RESULTS
Forty-three (20%) patients were diagnosed with Stages I (81%) and II (19%) CIAKI. The patients with CIAKI were older; they had higher baseline serum creatinine levels, a higher volume of contrast agent, a higher ratio of contrast medium volume to glomerular filtration rate, and lower left ventricular ejection fraction. Independent predictive factors for CIAKI were identified; these were chronic kidney disease, multivascular injury in the coronary bed, hospital therapy with loop diuretics, nephrotoxic antibiotics, or mineralocorticoid receptor antagonists.


CONCLUSIONS
The development of CIAKI is associated with poor outcomes, such as higher 30-day mortality and more frequent cardiovascular disease readmissions.
Department of Internal Propedeutics, Medical Institute, Peoples' Friendship University of Russia, Moscow, Russia.
Zh D
ZD
Kobalava
Department of Internal Propedeutics, Medical Institute, Peoples' Friendship University of Russia, Moscow, Russia.
S V
SV
Villevalde
Department of Internal Propedeutics, Medical Institute, Peoples' Friendship University of Russia, Moscow, Russia.
A A
AA
Gaskina
City Clinical Hospital Sixty-Four, Moscow Healthcare Department, Moscow, Russia.
V V
VV
Mayskov
Department of Internal Propedeutics, Medical Institute, Peoples' Friendship University of Russia, Moscow, Russia.
V S
VS
Moiseev
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000601:surgery*; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000009:adverse effects* / Q000379:methods; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D014283:Triiodobenzoic Acids / Q000009:adverse effects*
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol