Contrast-associated acute kidney injury in patients with diabetes mellitus following elective percutaneous coronary intervention: Insights from an iodixanol-acute kidney injury registry study

Background: Patients with diabetes mellitus (DM) are particularly susceptible to contrast-associated acute kidney injury (CA-AKI). However, few studies have evaluated CA-AKI stages in patients with DM following elective percutaneous coronary intervention (PCI) with iodixanol. Methods: Patients with DM who underwent elective PCI in 8 Chinese hospitals from May 2020 to November 2021 were prospectively enrolled in the Iodixanol-Acute Kidney Injury Registry (No. ChiCTR1800016719). According to the European Society of Urogenital Radiation on their CA-AKI diagnosis, and follow-up of major adverse renal and cardiovascular events (MARCE), CA-AKI and prognosis predictors were identified using logistic and Cox multivariable regression, respectively. Results: There were 1120 patients with DM included and the incidence of CA-AKI was 5.8 % (65/1120). However, most CA-AKI patients were at acute kidney injury stage 1 (96.9 %, 63/65). The dose of iodixanol was not an independent risk factor for CA-AKI, however, a hemoglobin level <110 g/L, a left ventricular ejection fraction (LVEF) <40 %, an estimated glomerular filtration rate <60 mL/min/1.73m2 , an N-terminal pro-B-type natriuretic peptide level >= 300 pg/mL, and the use of loop diuretics were independent risk factors. Only 3.5 % (39/1120) of patients experienced MARCE. Hypertension, LVEF <40 %, hemoglobin level <110 g/L, and age >75 years old were independent risk factors for MARCE, while in comparison to indobufen, aspirin is an independent protective factor against MARCE in diabetic patients. Conclusions: The incidence of CA-AKI in patients with DM who underwent PCI was low, mostly associated with mild renal impairment, and therefore did not increase the risk of MARCE. (c) 2025 Japanese College of Cardiology. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.