title: Chronic Kidney Disease Progression and Cardiovascular Outcomes Following Cardiac Catheterization-A Population-Controlled Study.
abstract: Studies of kidney disease associated with cardiac catheterization typically rely on billing records rather than laboratory data. We examined the associations between percutaneous coronary interventions, acute kidney injury, and chronic kidney disease progression using comprehensive Veterans Affairs clinical and laboratory databases.
  
  
  
  Patients undergoing percutaneous coronary interventions between 2005 and 2010 (N=24 405) were identified in the Veterans Affairs Clinical Assessment, Reporting, and Tracking registry and examined for associated acute kidney injury and chronic kidney disease development or progression relative to 24 405 matched population controls. Secondary outcomes analyzed included dialysis, acute myocardial infarction, and mortality. The incidence of chronic kidney disease progression following percutaneous coronary interventions complicated by acute kidney injury, following uncomplicated coronary interventions, and in matched controls were 28.66, 11.15, and 6.81 per 100 person-years, respectively. Percutaneous coronary intervention also increased the likelihood of chronic kidney disease progression in both the presence and absence of acute injury relative to controls in adjusted analyses (hazard ratio [HR], 5.02 [95% CI, 4.68-5.39]; and HR, 1.76 [95% CI, 1.70-1.86]). Among patients with estimated glomerular filtration rate <60 mL/min per 1.73 m2, acute kidney injury increased the likelihood of disease progression by 8-fold. Similar results were observed for all secondary outcomes.
  
  
  
  Acute kidney injury following percutaneous coronary intervention was associated with increased chronic kidney disease development and progression and mortality.
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice and Section of Cardiology, Department of Medicine, Geisel School of Medicine, Lebanon, NH jbrown@dartmouth.edu.
authors.forename: Jeremiah R
authors.initials: JR
authors.lastname: Brown
authors.affiliation: Section of Nephrology, Fletcher Allen Health Center, University of Vermont, Burlington, VT.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Solomon
authors.affiliation: Section of Nephrology and Research and Development Service, White River Junction Veterans Affairs Medical Center, Veterans Administration, White River Junction, VT.
authors.forename: R Brooks
authors.initials: RB
authors.lastname: Robey
authors.affiliation: VA Eastern Colorado Health Care System, University of Colorado School of Medicine, Denver, CO.
authors.forename: Meg E
authors.initials: ME
authors.lastname: Plomondon
authors.affiliation: VA Eastern Colorado Health Care System, University of Colorado School of Medicine, Denver, CO.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Maddox
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice and Section of Cardiology, Department of Medicine, Geisel School of Medicine, Lebanon, NH.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Marshall
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice and Section of Cardiology, Department of Medicine, Geisel School of Medicine, Lebanon, NH.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Nichols
authors.affiliation: Geriatrics Research, Education, and Clinical Care, Tennessee Valley Healthcare System, Veteran's Administration, Nashville, TN.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Matheny
authors.affiliation: VA Eastern Colorado Health Care System, University of Colorado School of Medicine, Denver, CO.
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Tsai
authors.affiliation: VA Eastern Colorado Health Care System, University of Colorado School of Medicine, Denver, CO.
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.affiliation: Department of Veterans Affairs, Veterans Rural Health Resource Center - Eastern Region, White River Junction, VT.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sarnak
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000453:epidemiology / Q000601:surgery; D000789:Angina, Unstable / Q000453:epidemiology / Q000601:surgery; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000601:surgery*; D000072658:Non-ST Elevated Myocardial Infarction / Q000453:epidemiology / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis / Q000706:statistics & numerical data; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D000072657:ST Elevation Myocardial Infarction / Q000453:epidemiology / Q000601:surgery; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D003287:Contrast Media
keywords: angioplasty; contrast media; kidney; morbidity; survival