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Development of a novel score to predict the risk of acute kidney injury in patient with acute myocardial infarction

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Abstract

Background

Acute kidney injury (AKI) is common in patients with acute myocardial infarction. AKI in this setting is associated with short- and long-term adverse events. The aim of this study was to develop a simple score to predict AKI in patients presenting with acute myocardial infarction based on data available at time of admission.

Methods

This was a retrospective analysis of data collected as part of the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) registry at a tertiary care center between 1/1/2011 and 12/31/2013. Data were collected prospectively for all patients who presented within 24 h of the onset of myocardial infarction. AKI was defined as an increase in creatinine from admission level to peak level of ≥0.3 mg/dl or by ≥50 %. Patients with history of end-stage renal disease requiring renal replacement therapy were excluded.

Results

Of 1107 patients included in the study, 147 (13.3 %) developed AKI. The following factors were independently associated with increased risk for AKI: cardiac arrest, decompensated heart failure on presentation, diabetes mellitus, hypertension, anemia, impaired renal function on presentation, and tachycardia on presentation. These factors were combined to form a new predictive tool. The new score showed excellent discrimination for AKI: the area under the receiver operating characteristic curve (AUROC) was 0.76 (95 % confidence interval 0.72–0.80).

Conclusion

A simple score using clinical and laboratory data available on admission can predict the risk of AKI in patients presenting with acute myocardial infarction.

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Acknowledgments

The authors would like to acknowledge Mrs. Elizabeth Purinton and the cardiovascular institute at Florida Hospital in Orlando, FL for their help with the study.

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Authors and Affiliations

  1. Florida Hospital Internal Medicine Residency Program, 2501 N Orange Ave, Suite 235, Orlando, FL, 32804, USA

    Khalid Abusaada, Cai Yuan, Rafay Sabzwari, Khurram Butt & Aadil Maqsood

Authors
  1. Khalid Abusaada
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  2. Cai Yuan
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  3. Rafay Sabzwari
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  4. Khurram Butt
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  5. Aadil Maqsood
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Corresponding author

Correspondence to Khalid Abusaada.

Ethics declarations

Informed consent

Informed consent was obtained from all individual participants included in the study before enrollment in the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) registry.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of retrospective study formal consent is not required. The study was approved by the local institutional office of research administration and institutional review board (IRB).

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No funding was received for this study.

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Abusaada, K., Yuan, C., Sabzwari, R. et al. Development of a novel score to predict the risk of acute kidney injury in patient with acute myocardial infarction. J Nephrol 30, 419–425 (2017). https://doi.org/10.1007/s40620-016-0326-1

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  • DOI: https://doi.org/10.1007/s40620-016-0326-1

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