Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose
Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose
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DOI：
10.1016/s0002-9149(02)02771-6
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发表时间：
2002-11-15
影响因子：
2.8
通讯作者：
Moscucci, M
中科院分区：
文献类型：
--
作者：
Freeman, RV;O'Donnell, M;Moscucci, M
本研究旨在确定经皮冠状动脉介入治疗（PCI）后需要透析的肾病（NRD）的发生率、危险因素和住院结果，并评估体重和肌酐调整的最大x线造影剂（MRCD）对NRD的作用。数据来自16,592个pci的注册表。数据被分为开发集和测试集。确定了单因素预测因子，并建立了多因素logistic回归模型。每个患者的MRCD计算为：MRCD = 5 ml x体重-（公斤）/血清肌酐（毫克/分升）。通过对受者工作特性曲线的分析来评估预测的准确性。在发展组中，41名患者（0.44%）发展为NRD，随后住院死亡。利率为39.0%。NRD随着基线肾功能的恶化而增加。其他危险因素包括外周血管疾病、糖尿病、充血性心力衰竭和心源性休克。危险因素的数量与NRD之间存在直接关系。在基线危险因素调整后，MRCD是NRD最强的独立预测因子（调整优势比为6.2,95%置信区间为3.0 ~ 12.8）。超过MRCD的患者的NRD和住院死亡率均显著高于未超过MRCD的患者(p
This study was undertaken to determine the incidence, risk factors, and in-hospital outcome of nephropathy requiring dialysis (NRD) after percutaneous coronary intervention (PCI), and to evaluate the role of a weight- and creatinine-adjusted maximum radiographic contrast close (MRCD) on NRD. Data were obtained from a registry of 16,592 PCIs. The data were divided into development and test sets. Univariate predictors were identified and a multivariate logistic regression model was developed. The MRCD was calculated for each patient as: MRCD = 5 ml x body weight -(kilograms)/ serum creatinine (milligrams per deciliter). Predictive accuracy was assessed by receiver-operating characteristic curve analysis.. In the development set, 41 patients (0.44%) developed NRD with a subsequent in-hospital mortality. rate of 39.0%. NRD increased with worsening baseline renal dysfunction. Other risk factors included peripheral vascular disease, diabetes mellitus, congestive heart failure, and cardiogenic shock. There was a direct relation between the number of risk factors and NRD. After adjustment for baseline risk factors, MRCD was the strongest independent predictor of NRD (adjusted odds ratio 6.2, 95% confidence interval 3.0 to 12.8). NRD and in-hospital mortality were both significantly higher in patients who exceeded the MRCD compared with patients who did not (p