title: A New Preprocedure Risk Score for Predicting Contrast-Induced Acute Kidney Injury.
abstract: Most of the risk models for predicting contrast-induced acute kidney injury (CI-AKI) are available for only postcontrast exposure prediction; however, prediction before the procedure is more valuable in practice. This study aimed to develop a risk scoring system based on preprocedural characteristics for early prediction of CI-AKI in patients after coronary angiography or percutaneous coronary intervention (PCI).
  
  
  
  We prospectively recruited 1777 consecutive patients who were randomized in an approximate 3:2 ratio to create a development data set (n = 1076) and a validation data set (n = 701). A risk score model based on preprocedural risk factors was developed using stepwise logistic regression. Validation was performed by bootstrap and split-sample methods.
  
  
  
  The occurrence of CI-AKI was 5.97% (106 of 1777), 5.95% (64 of 1076), and 5.99% (42 of 701) in the overall, developmental, and validation data sets, respectively. The risk score was developed with 5 prognostic factors (age, serum creatinine levels, N-terminal pro b-type natriuretic peptide levels, high-sensitivity C-reactive protein, and primary PCI), ranged from 0-36, and was well calibrated (Hosmer-Lemeshow χ2= 4.162; P = 0.842). Good discrimination was obtained both in the developmental and validation data sets (C-statistic, 0.809 and 0.798, respectively). The risk score was highly and positively associated with CI-AKI (P for trend < 0.001) in-hospital and long-term outcomes.
  
  
  
  The novel risk score model we developed is a simple and accurate tool for early/preprocedural prediction of CI-AKI in patients undergoing coronary angiography or PCI. This tool allows assessment of the risk of CI-AKI before contrast exposure, allowing for timely initiation of appropriate preventive measures.
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, and Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
authors.forename: Chongyang
authors.initials: C
authors.lastname: Duan
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, and Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
authors.forename: Yingshu
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, and Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
authors.forename: Lizhi
authors.initials: L
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, and Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
authors.forename: Kaike
authors.initials: K
authors.lastname: Ping
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, and Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China; Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington DC, USA.
authors.forename: Ming T
authors.initials: MT
authors.lastname: Tan
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Tan
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. Electronic address: chenjiyandr@126.com.
authors.forename: Jiyan
authors.initials: J
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, and Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China. Electronic address: chenpy99@126.com.
authors.forename: Pingyan
authors.initials: P
authors.lastname: Chen
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology*; D000368:Aged; D002681:China / Q000453:epidemiology; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods; D057234:Preoperative Period; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D013997:Time Factors
chemical_list: D003287:Contrast Media; D003404:Creatinine