Skip to main content
SpringerLink
Log in

Trajectory of renal function change and kidney injury after percutaneous coronary intervention in patients with stable coronary artery disease

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Acute kidney injury usually assessed within 48 h after percutaneous coronary intervention (PCI) is associated with poor clinical outcomes, and persistent kidney damage is also strongly related to long-term mortality. However, little is known about longitudinal renal function change from a very early period to long-term follow-up after PCI. A total of 327 patients with stable coronary artery disease underwent elective PCI. Renal function was assessed with serum creatinine levels and estimated glomerular filtration rate (eGFR) at baseline, 1 day after PCI, at 1 year and at the latest follow-up. Kidney injury was defined as an increase in creatinine levels ≥ 0.3 mg/dl or ≥ 50% from baseline at each timepoint. Major adverse cardiovascular events (MACE) was defined as a composite of death, myocardial infarction, and stroke. eGFR was significantly increased 1 day after PCI, while it was progressively decreased at 1-year and long-term follow-up (median 28 months). Overall, eGFR was declined by − 2.3 ml/min/1.73 m2 per year. Only one (0.3%) patient developed kidney injury 1 day after PCI, whereas kidney injury at 1-year and long-term follow-up was observed in 15 (4.6%) and 27 (8.3%). During the follow-up period, 23 (7.0%) patients had MACE. The incidence of subsequent MACE was significantly higher in patients with kidney injury at 1 year than those without. In conclusion, kidney injury within 24 h after elective PCI was rarely observed. eGFR was progressively decreased over time, and mid-term kidney injury at 1 year was associated with future MACE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kidney Disease Improving Global Outcomes (KDIGO) (2012) Clinical practice guideline for acute kidney injury. Kidney Int Suppl 2:1–138

    Article  Google Scholar 

  2. Mehran R, Dangas GD, Weisbord SD (2019) Contrast-associated acute kidney injury. N Engl J Med 380:2146–2155

    Article  CAS  Google Scholar 

  3. Almendarez M, Gurm HS, Mariani J Jr, Montorfano M, Brilakis ES, Mehran R, Azzalini L (2019) Procedural strategies to reduce the incidence of contrast-induced acute kidney injury during percutaneous coronary intervention. JACC Cardiovasc Interv 12:1877–1888

    Article  Google Scholar 

  4. Vanmassenhove J, Kielstein J, Jörres A, Biesen WV (2017) Management of patients at risk of acute kidney injury. Lancet 389:2139–2151

    Article  Google Scholar 

  5. Seto AH, Shroff A, Abu-Fadel M, Blankenship JC, Boudoulas KD, Cigarroa JE, Dehmer GJ, Feldman DN, Kolansky DM, Lata K, Swaminathan RV, Rao SV (2018) Length of stay following percutaneous coronary intervention: an expert consensus document update from the society for cardiovascular angiography and interventions. Catheter Cardiovasc Interv 92:717–731

    Article  Google Scholar 

  6. Abe M, Morimoto T, Nakagawa Y, Furukawa Y, Ono K, Kato T, Kadota K, Ando K, Ishii M, Masunaga N, Akao M, Kimura T (2017) Impact of transient or persistent contrast-induced nephropathy on long-term mortality after elective percutaneous coronary intervention. Am J Cardiol 120:2146–2153

    Article  Google Scholar 

  7. Saito Y, Kobayashi Y, Fujii K, Sonoda S, Tsujita K, Hibi K, Morino Y, Okura H, Ikari Y, Honye J (2020) Clinical expert consensus document on standards for measurements and assessment of intravascular ultrasound from the Japanese Association of Cardiovascular Intervention and Therapeutics. Cardiovasc Interv Ther 35:1–12

    Article  CAS  Google Scholar 

  8. Sonoda S, Hibi K, Okura H, Fujii K, Honda Y, Kobayashi Y (2020) Current clinical use of intravascular ultrasound imaging to guide percutaneous coronary interventions. Cardiovasc Interv Ther 35:30–36

    Article  Google Scholar 

  9. Fujii K, Kubo T, Otake H, Nakazawa G, Sonoda S, Hibi K, Shinke T, Kobayashi Y, Ikari Y, Akasaka T (2020) Expert consensus statement for quantitative measurement and morphological assessment of optical coherence tomography. Cardiovasc Interv Ther 35:13–18

    Article  Google Scholar 

  10. Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S (2010) Modification of the CKD epidemiology collaboration (CKD-EPI) equation for Japanese: accuracy and use for population estimates. Am J Kidney Dis 56:32–38

    Article  Google Scholar 

  11. Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Hayashi H, Koshi E, Kosugi T, Yasuda Y, Japanese Society of Nephrology; Japan Radiological Society, Japanese Circulation Society Joint Working Group (2019) Guideline on the use of iodinated contrast media in patients with kidney disease 2018. Circ J 83:2572–2607

    Article  Google Scholar 

  12. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, Katus HA, Lindahl B, Morrow DA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow RO, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasché P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Simoons ML, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S (2012) Third universal definition of myocardial infarction. Circulation 126:2020–2035

    Article  Google Scholar 

  13. Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, Mintz GS, Lansky AJ, Moses JW, Stone GW, Leon MB, Dangas G (2004) A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 44:1393–1399

    PubMed  Google Scholar 

  14. Bartholomew BA, Harjai KJ, Dukkipati S, Boura JA, Yerkey MW, Glazier S, Grines CL, O'Neill WW (2004) Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol 93:1515–1519

    Article  Google Scholar 

  15. Tsai TT, Patel UD, Chang TI, Kennedy KF, Masoudi FA, Matheny ME, Kosiborod M, Amin AP, Weintraub WS, Curtis JP, Messenger JC, Rumsfeld JS, Spertus JA (2014) Validated contemporary risk model of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the National Cardiovascular Data Registry Cath-PCI Registry. J Am Heart Assoc 3:e001380

    Article  Google Scholar 

  16. Watanabe M, Saito Y, Aonuma K, Hirayama A, Tamaki N, Tsutsui H, Murohara T, Ogawa H, Akasaka T, Yoshimura M, Sato A, Takayama T, Sakakibara M, Suzuki S, Ishigami K, Onoue K, CINC-J Study Investigators (2016) Prediction of contrast-induced nephropathy by the serum creatinine level on the day following cardiac catheterization. J Cardiol 68:412–418

    Article  Google Scholar 

  17. Caspi O, Habib M, Cohen Y, Kerner A, Roguin A, Abergel E, Boulos M, Kapeliovich MR, Beyar R, Nikolsky E, Aronson D (2017) Acute kidney injury after primary angioplasty: is contrast-induced nephropathy the culprit? J Am Heart Assoc 6:e005715

    Article  Google Scholar 

  18. Otsuka K, Shimada K, Katayama H, Nakamura H, Ishikawa H, Takeda H, Fujimoto K, Kasayuki N, Yoshiyama M (2019) Prognostic significance of renal dysfunction and its change pattern on outcomes in patients with acute coronary syndrome treated with emergent percutaneous coronary intervention. Heart Vessels 34:735–744

    Article  Google Scholar 

  19. Liu Y, Duan CY, Wang K, Bei WJ, Guo XS, Li HL, Wang Y, Chen SQ, Xian Y, Chen PY, Geng QS, Tan N, Chen JY (2017) Could late measurement of serum creatinine be missed for patients without early increase in serum creatinine following coronary angiography? Medicine (Baltimore) 96:e8460

    Article  CAS  Google Scholar 

  20. Ribichini F, Graziani M, Gambaro G, Pasoli P, Pighi M, Pesarini G, Abaterusso C, Yabarek T, Brunelleschi S, Rizzotti P, Lupo A, Vassanelli C (2010) Early creatinine shifts predict contrast-induced nephropathy and persistent renal damage after angiography. Am J Med 123:755–763

    Article  CAS  Google Scholar 

  21. Chia YC, Lim HM, Ching SM (2016) Long-term visit-to-visit blood pressure variability and renal function decline in patients with hypertension over 15 years. J Am Heart Assoc 5:e003825

    Article  Google Scholar 

  22. No authors listed (2013) Chapter 2: definition, identification, and prediction of CKD progression. Kidney Int Suppl 3:63–72

  23. Nakahashi T, Tada H, Sakata K, Yakuta Y, Yoshida T, Tanaka Y, Nomura A, Terai H, Horita Y, Ikeda M, Namura M, Takamura M, Kawashiri MA (2020) Impact of concomitant peripheral artery disease on contrast-induced acute kidney injury and mortality in patients with acute coronary syndrome after percutaneous coronary intervention. Heart Vessels 35:1360–1367

    Article  Google Scholar 

  24. Brugts JJ, Knetsch AM, Mattace-Raso FU, Hofman A, Witteman JC (2005) Renal function and risk of myocardial infarction in an elderly population: the Rotterdam Study. Arch Intern Med 165:2659–2665

    Article  Google Scholar 

  25. Kurogi K, Ishii M, Sakamoto K, Komaki S, Marume K, Kusaka H, Yamamoto N, Arima Y, Yamamoto E, Kaikita K, Tsujita K (2019) Persistent renal dysfunction in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. J Am Heart Assoc 8:e014096

    Article  Google Scholar 

  26. Katoh H, Nozue T, Horie K, Sozu T, Inoue N, Michishita I (2019) RenalGuard system to prevent contrast-induced acute kidney injury in Japanese patients with renal dysfunction; RESPECT KIDNEY study. Cardiovasc Interv Ther 34:105–112

    Article  Google Scholar 

  27. Sakai K, Ikari Y, Nanasato M, Umetsu H, Okutsu M, Takikawa T, Sumitsuji S, Sadamatsu K, Takada M, Kato Y, Ogasawara N, Otowa K (2019) Impact of intravascular ultrasound-guided minimum-contrast coronary intervention on 1-year clinical outcomes in patients with stage 4 or 5 advanced chronic kidney disease. Cardiovasc Interv Ther 34:234–241

    Article  CAS  Google Scholar 

  28. Coca SG (2013) Is it AKI or nonrecovery of renal function that is important for long-term outcomes? Clin J Am Soc Nephrol 8:173–176

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan

    Yuki Deguchi, Motohiro Nakao, Hirokazu Shiraishi, Naoya Sakamoto & Satoru Kobayashi

  2. Yale University School of Medicine, New Haven, USA

    Yuichi Saito

  3. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan

    Yuichi Saito & Yoshio Kobayashi

Authors
  1. Yuki Deguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuichi Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Motohiro Nakao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirokazu Shiraishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Naoya Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Satoru Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yoshio Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuichi Saito.

Ethics declarations

Conflict of interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Deguchi, Y., Saito, Y., Nakao, M. et al. Trajectory of renal function change and kidney injury after percutaneous coronary intervention in patients with stable coronary artery disease. Heart Vessels 36, 315–320 (2021). https://doi.org/10.1007/s00380-020-01701-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-020-01701-1

Keywords

Search

Navigation