Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury

Abstract Congestive heart failure (HF) is a known risk factor of contrast-induced acute kidney injury (CI-AKI). However, the relationship of the classification and severity of HF with CI-AKI remains under-explored. From January 2009 to April 2019, we recruited patients undergoing elective PCI who ha...

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Autores principales:	Tian Xu, Maoning Lin, Xiaohua Shen, Min Wang, Wenjuan Zhang, Liding Zhao, Duanbin Li, Yi Luan, Wenbin Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/80fa2c0d65ae4ee6a7ce6a585548ac1e
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spelling	oai:doaj.org-article:80fa2c0d65ae4ee6a7ce6a585548ac1e2021-12-02T16:31:51ZAssociation of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury10.1038/s41598-021-94910-12045-2322https://doaj.org/article/80fa2c0d65ae4ee6a7ce6a585548ac1e2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94910-1https://doaj.org/toc/2045-2322Abstract Congestive heart failure (HF) is a known risk factor of contrast-induced acute kidney injury (CI-AKI). However, the relationship of the classification and severity of HF with CI-AKI remains under-explored. From January 2009 to April 2019, we recruited patients undergoing elective PCI who had complete pre- and post-operative creatinine data. According to the levels of ejection fraction (EF), HF was classified as HF with reduced EF (HFrEF) [EF < 40%], HF with mid-range EF (HFmrEF) [EF 40–49%] and HF with preserved EF (HFpEF) [EF ≥ 50%]. CI-AKI was defined as an increase of either 25% or 0.5 mg/dL (44.2 μmoI/L) in serum baseline creatinine level within 72 h following the administration of the contrast agent. A total of 3848 patients were included in the study; mean age 67 years old, 33.9% females, 48.1% with HF, and 16.9% with CI-AKI. In multivariate logistic regression analysis, HF was an independent risk factor for CI-AKI (OR 1.316, p value < 0.05). Among patients with HF, decreased levels of EF (OR 0.985, p value < 0.05) and elevated levels of N-terminal pro b-type natriuretic peptide (NT-proBNP) (OR 1.168, p value < 0.05) were risk factors for CI-AKI. These results were consistent in subgroup analysis. Patients with HFrEF were more likely to develop CI-AKI than those with HFmrEF or HFpEF (OR 0.852, p value = 0.031). Additionally, lower levels of EF were risk factors for CI-AKI in the HFrEF and HFmrEF groups, but not in the HFpEF group. NT-proBNP was an independent risk factor for CI-AKI in the HFrEF, HFmrEF and HFpEF groups. Elevated levels of NT-proBNP are independent risk factors for CI-AKI irrespective of the classification of HF. Lower levels of EF were risk factors for CI-AKI in the HFrEF and HFmrEF groups, but not in the HFpEF group.Tian XuMaoning LinXiaohua ShenMin WangWenjuan ZhangLiding ZhaoDuanbin LiYi LuanWenbin ZhangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tian Xu Maoning Lin Xiaohua Shen Min Wang Wenjuan Zhang Liding Zhao Duanbin Li Yi Luan Wenbin Zhang Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury
description	Abstract Congestive heart failure (HF) is a known risk factor of contrast-induced acute kidney injury (CI-AKI). However, the relationship of the classification and severity of HF with CI-AKI remains under-explored. From January 2009 to April 2019, we recruited patients undergoing elective PCI who had complete pre- and post-operative creatinine data. According to the levels of ejection fraction (EF), HF was classified as HF with reduced EF (HFrEF) [EF < 40%], HF with mid-range EF (HFmrEF) [EF 40–49%] and HF with preserved EF (HFpEF) [EF ≥ 50%]. CI-AKI was defined as an increase of either 25% or 0.5 mg/dL (44.2 μmoI/L) in serum baseline creatinine level within 72 h following the administration of the contrast agent. A total of 3848 patients were included in the study; mean age 67 years old, 33.9% females, 48.1% with HF, and 16.9% with CI-AKI. In multivariate logistic regression analysis, HF was an independent risk factor for CI-AKI (OR 1.316, p value < 0.05). Among patients with HF, decreased levels of EF (OR 0.985, p value < 0.05) and elevated levels of N-terminal pro b-type natriuretic peptide (NT-proBNP) (OR 1.168, p value < 0.05) were risk factors for CI-AKI. These results were consistent in subgroup analysis. Patients with HFrEF were more likely to develop CI-AKI than those with HFmrEF or HFpEF (OR 0.852, p value = 0.031). Additionally, lower levels of EF were risk factors for CI-AKI in the HFrEF and HFmrEF groups, but not in the HFpEF group. NT-proBNP was an independent risk factor for CI-AKI in the HFrEF, HFmrEF and HFpEF groups. Elevated levels of NT-proBNP are independent risk factors for CI-AKI irrespective of the classification of HF. Lower levels of EF were risk factors for CI-AKI in the HFrEF and HFmrEF groups, but not in the HFpEF group.
format	article
author	Tian Xu Maoning Lin Xiaohua Shen Min Wang Wenjuan Zhang Liding Zhao Duanbin Li Yi Luan Wenbin Zhang
author_facet	Tian Xu Maoning Lin Xiaohua Shen Min Wang Wenjuan Zhang Liding Zhao Duanbin Li Yi Luan Wenbin Zhang
author_sort	Tian Xu
title	Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury
title_short	Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury
title_full	Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury
title_fullStr	Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury
title_full_unstemmed	Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury
title_sort	association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/80fa2c0d65ae4ee6a7ce6a585548ac1e
work_keys_str_mv	AT tianxu associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT maoninglin associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT xiaohuashen associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT minwang associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT wenjuanzhang associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT lidingzhao associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT duanbinli associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT yiluan associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury AT wenbinzhang associationoftheclassificationandseverityofheartfailurewiththeincidenceofcontrastinducedacutekidneyinjury
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Association of the classification and severity of heart failure with the incidence of contrast-induced acute kidney injury

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