Author + information
- Serkan Yıldırım1,
- Mehmet Kayrak1,
- Mehmet Doğuşcan Eriş2,
- Hakan Akıllı1,
- Yalçın Solak3 and
- Ahmet Lütfi Sertdemir1
In this study, whether ankle-brachial index (ABI) is an independent predictor for acute kidney injury (AKI) in patients taken to the KAG laboratory for coronary procedures is aimed.
Before the coronary procedures in KAG laboratory; serum creatine (SCr), glomerular filtration rate (GFR), and doppler derived ABI were measured in all patients that are accepted to either Cardiology Department or Coronary Intensive Care Unit of Necmettin Erbakan University between May 2012-March 2013. Patients' SCr were monitored until at least 48 hours after the procedure and increases bigger than 0.3 mg/dl in this value were considered as AKI.
The ABI means of patients who developed AKI and those who didnot were found 1.17±0.12 and 1.22±0.17 respectively (p:0.008). ABI>1.3 is about 3 times more in patients who developed AKI than the group did not (36.8% vs 13%, p <0.001). In this study, independent predictors of AKI were ABI (odds: 11.4 (1.81-72.84 with 95% CI), p=0.01), EF (odds: 0.91 (0.85-0.98 with 95% CI), p=0.007), and preoperative GFR (odds: 0.96 (0.93-0.98 with 95% CI), p=0.001)). It is determined that ABI>1.30 shows the development of AKI with 36.8% sensitivity and 87.5% specificity. (Positive predictive value: 25.3, negative predictive value: 92.3).
In many previous studies, patients with increased ABI (arterial stiffness) were detected to have an increased cardiovascular mortality incident. Increased AKI in patients with high ABI whom are detected during this study could be a reason behind the increase in cardiovascular mortality in this hospital.
To foresee the contrast related AKI development which is a feared complication is important and in this regard, ABI>1.3 may be a marker.
|179 (36,2)||25 (43,9)||0.26|
|DM n (%)||152 (30,8)||23 (40,4)||0.14|
|HT n (%)||297 (60,1)||37 (64,9)||0,48|
|Smoking (%)||187 (38,1)||25 (44,8)||0.32|
|Prior KAG n (%)||210 (42,5)||21 (36,8)||0.41|
|GFR before the procedure||99,30±35,34||64,23±30,98||0,008|
|ABI>1,3 n (%)||64 (13,0)||21 (36,8)||<0,001|
|Total contrast used||96,09±39,01||102,89±37,40||0,21|
|Total procedure time||26,43±11,9||29,47±12,77||0,09|
|ACE İnh/ARB n (%)||346 (70,1)||37 (64,9)||0,48|