Trends in incidence and long-term prognosis of acute kidney injury following coronary angiography in Chinese cohort with 11,943 patients from 2013 to 2017: an observational study

Jin Liu, Qiang Li, Disheng Lai, Guoqin Chen, Bo Wang, Liwei Liu, Haozhang Huang, Zhubin Lun, Ming Ying, Guanzhong Chen, Zhidong Huang, Danyuan Xu, Liangguang Meng, Xiaoming Yan, Weiyan Qiu, Ning Tan, Jiyan Chen, Yong Liu, Shiqun Chen, Jin Liu, Qiang Li, Disheng Lai, Guoqin Chen, Bo Wang, Liwei Liu, Haozhang Huang, Zhubin Lun, Ming Ying, Guanzhong Chen, Zhidong Huang, Danyuan Xu, Liangguang Meng, Xiaoming Yan, Weiyan Qiu, Ning Tan, Jiyan Chen, Yong Liu, Shiqun Chen

Abstract

Background: Contrast-associated acute kidney injury (CA-AKI) is a common complication with poor prognosis after coronary angiography (CAG). With the prevention methods widely being implemented, the temporal trends of incidence and mortality of CA-AKI are still unknown over the last five years. The study aims to determine the incidence and prognosis of CA-AKI in China.

Methods: This retrospective cohort study was based on the registry at Guangdong Provincial People's Hospital in China (ClinicalTrials.gov NCT04407936). We analyzed data from hospitalization patients who underwent CAG and with preoperative and postoperative serum creatinine (Scr) values from January 2013 to December 2017.

Results: 11,943 patients were included in the study, in which the mean age was 63.01 ± 10.79 years and 8,469 (71.1 %) were male. The overall incidence of CA-AKI was 11.2 %. Compared with 2013, the incidence of CA-AKI in 2017 was significantly increased from 9.7 to 13.0 % (adjusted odds ratios [aOR], 1.38; 95 %CI, 1.13-1.68; P-value < 0.01, P for trend < 0.01). The temporal trends of incidence among patients of different ages and genders yielded similar findings. During a standardized follow-up of 1 year, 178 (13.7 %) CA-AKI patients died in total, which showed no obvious decreased trend in this 5 five years from 21.1 to 16.5 (adjusted hazard ratio [aHR], 0.72; 95 %CI, 0.36-1.45; P-value = 0.35, P for trend = 0.24).

Conclusions: Our Chinese cohort showed that the incidence of CA-AKI increased significantly, while CA-AKI associated mortality showed no obvious decreased trend in the last five years. Our findings support more active measures to prevent CA-AKI and improve the prognosis of CA-AKI patients.

Keywords: Contrast-associated acute kidney injury; Incidence; Mortality; Trends.

Conflict of interest statement

The author declares that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trends in incidence and long-term mortality of CA-AKI Trends in incidence of CA-AKI among patients underwent coronary angiography in China between 2013 and 2017 From 2013 to 2017, the incidence of CA-AKI was significantly increased from 9.7–13.0 % (adjusted odds ratios [aOR], 1.38; 95 %CI, 1.13–1.68; P value < 0.01, P for trend < 0.01) Trends of long-term mortality during 1-year follow-up period among CA-AKI patients in China between 2013 and 2017 From 2013 to 2017, the long-term mortality during 1-year follow-up period showed no obvious variation trend from 21.1 to 16.5 per 1,000 person-years (adjusted hazard ratio [aHR], 0.72; 95 %CI, 0.36–1.45; P value = 0.35, P for trend = 0.24)
Fig. 2
Fig. 2
Trends in incidence and long-term mortality of 4 different Subgroups between 2013 and 2017 A. Trends in incidence of CA-AKI among male (P for trend<0.01) and female (P for trend = 0.03); B. Trends of 1-year mortality per 1,000 person-year among male (P for trend = 0.55) and female (P for trend = 0.80); C. Trends in incidence of CA-AKI among < 65 years group (P for trend = 0.01) and ≥ 65 years group (P for trend<0.01); D. Trends of 1-year mortality per 1,000 person-year among < 65 years group (P for trend = 0.08) and ≥ 65 years group (P for trend = 0.20)

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