Academic Journal
Effects of body habitus on contrast-induced acute kidney injury after percutaneous coronary intervention.
| Title: | Effects of body habitus on contrast-induced acute kidney injury after percutaneous coronary intervention. |
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| Authors: | Toshiki Kuno, Yohei Numasawa, Mitsuaki Sawano, Toshiomi Katsuki, Masaki Kodaira, Ikuko Ueda, Masahiro Suzuki, Shigetaka Noma, Koji Negishi, Shiro Ishikawa, Hiroaki Miyata, Keiichi Fukuda, Shun Kohsaka |
| Source: | PLoS ONE, Vol 13, Iss 9, p e0203352 (2018) |
| Publisher Information: | Public Library of Science (PLoS), 2018. |
| Publication Year: | 2018 |
| Collection: | LCC:Medicine LCC:Science |
| Subject Terms: | Medicine, Science |
| More Details: | BACKGROUND:Limiting the contrast volume to creatinine clearance (V/CrCl) ratio is crucial for preventing contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). However, the incidence of CI-AKI and the distribution of V/CrCl ratios may vary according to patient body habitus. OBJECTIVE:We aimed to identify the clinical factors predicting CI-AKI in patients with different body mass indexes (BMIs). METHODS:We evaluated 8782 consecutive patients undergoing PCI and who were registered in a large Japanese database. CI-AKI was defined as an absolute serum creatinine increase of 0.3 mg/dL or a relative increase of 50%. The effect of the V/CrCl ratio relative to CI-AKI incidence was evaluated within the low- (≤25 kg/m2) and high- (>25 kg/m2) BMI groups, with a V/CrCl ratio > 3 considered to be a risk factor for CI-AKI. RESULTS:A V/CrCl ratio > 3 was predictive of CI-AKI, regardless of BMI (low-BMI group: odds ratio [OR], 1.77 [1.42-2.21]; P < 0.001; high-BMI group: OR, 1.67 [1.22-2.29]; P = 0.001). The relationship between BMI and CI-AKI followed a reverse J-curve relationship, although baseline renal dysfunction (creatinine clearance 3 (37.3% vs. 20.4%) were predominant in the low-BMI group. Indeed, low BMI was a significant predictor of a V/CrCl ratio > 3 (OR per unit decrease in BMI, 1.08 [1.05-1.10]; P < 0.001). CONCLUSIONS:A V/CrCl ratio > 3 was strongly associated with the occurrence of CI-AKI. Importantly, we also identified a tendency for physicians to use higher V/CrCl ratios in lean patients. Thus, recognizing this trend may provide a therapeutic target for reducing the incidence of CI-AKI. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1932-6203 |
| Relation: | http://europepmc.org/articles/PMC6136739?pdf=render; https://doaj.org/toc/1932-6203 |
| DOI: | 10.1371/journal.pone.0203352 |
| Access URL: | https://doaj.org/article/05a44beea80f4c0b8014757e8bd6715c |
| Accession Number: | edsdoj.05a44beea80f4c0b8014757e8bd6715c |
| Database: | Directory of Open Access Journals |
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| ISSN: | 19326203 |
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| DOI: | 10.1371/journal.pone.0203352 |
| Published in: | PLoS ONE |
| Language: | English |