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A prediction model of contrast-associated acute kidney injury in patients with hypoalbuminemia undergoing coronary angiography.

Abstract：

BACKGROUND:Risk stratification is recommended as the key step to prevent contrast-associated acute kidney injury (CA-AKI) among at-risk patients following coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). Patients with hypoalbuminemia are prone to CA-AKI and do not have their own risk stratification tool. Therefore, this study developed and validated a new model for predicting CA-AKI among hypoalbuminemia patients CAG/PCI. METHODS:1272 patients with hypoalbuminemia receiving CAG/PCI were enrolled and randomly allocated (2:1 ratio) into the development cohort (n = 848) and the validation cohort (n = 424). CA-AKI was defined as an increase of ≥0.3 mg/dL or 50% in serum creatinine (SCr) compared to baseline in the 48 to 72 h after CAG/PCI. A prediction model was established with independent predictors according to stepwise logistic regression, showing as a nomogram. The discrimination of the new model was evaluated by the area under the curve (AUC) and was compared to the classic Mehran CA-AKI model. The Hosmer-Lemeshow test was conducted to assess the calibration of our model. RESULTS:Overall, 8.4% (71/848) patients of the development group and 11.2% (48/424) patients of the validation group experienced CA-AKI. A new nomogram included estimated glomerular filtration rate (eGFR), serum albumin (ALB), age and the use of intra-aortic balloon pump (IABP); showed better predictive ability than the Mehran score (C-index 0.756 vs. 0.693, p = 0.02); and had good calibration (Hosmer-Lemeshow test p = 0.187). CONCLUSIONS:We developed a simple model for predicting CA-AKI among patients with hypoalbuminemia undergoing CAG/PCI, but our findings need validating externally. TRIAL REGISTRATION:http://www.ClinicalTrials.gov NCT01400295 , retrospectively registered 21 July 2011.

journal_name

BMC Cardiovasc Disord

journal_title

BMC cardiovascular disorders

authors

Liu L,Liu J,Lei L,Wang B,Sun G,Guo Z,He Y,Song F,Lun Z,Liu B,Chen G,Chen S,Yang Y,Liu Y,Chen J

doi

10.1186/s12872-020-01689-6

subject

Has Abstract

pub_date

2020-08-31 00:00:00

pages

399

issue

issn

1471-2261

pii

10.1186/s12872-020-01689-6

journal_volume

pub_type

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A prediction model of contrast-associated acute kidney injury in patients with hypoalbuminemia undergoing coronary angiography.