Safe Hydration to Prevent Contrast-Induced Acute Kidney Injury and Worsening Heart Failure in Patients with Renal Insufficiency and Heart Failure Undergoing Coronary Angiography or Percutaneous Coronary Intervention

被引：10

作者：

Bei, Wei-jie ^{[1
,3
]}

Wang, Kun ^{[1
,2
,3
]}

Li, Hua-long ^{[1
,3
]}

Guo, Xiao-sheng ^{[1
,3
]}

Guo, Wei ^{[1
,3
]}

Abuduaini, Tuerxunjiang ^{[1
,3
]}

Chen, Shi-qun ^{[2
,3
]}

Islam, Sheikh Mohammed Shariful ^{[4
]}

Chen, Peng-yuan ^{[1
,3
]}

Chen, Ji-yan ^{[1
,3
]}

Liu, Yong ^{[1
,3
]}

Tan, Ning ^{[1
,3
]}

机构：

[1] Guangdong Gen Hosp, Guangdong Acad Med Sci, Guangdong Cardiovasc Inst, Dept Cardiol,Guangdong Key Lab Coronary Dis, Guangzhou, Guangdong, Peoples R China

[2] Southern Med Univ, Dept Grad Sch, Guangzhou, Guangdong, Peoples R China

[3] South China Univ Technol, Sch Med, Guangzhou, Guangdong, Peoples R China

[4] Univ Sydney, George Inst Global Hlth, Camperdown, NSW, Australia

来源：

INTERNATIONAL HEART JOURNAL | 2019年 / 60卷 / 02期

关键词：

Hydration volume/weight; Long-term mortality; INDUCED NEPHROPATHY; TASK-FORCE; EPIDEMIOLOGY; PATHOGENESIS; ASSOCIATION; DYSFUNCTION; GUIDELINES; SOCIETY; DISEASE;

D O I：

10.1536/ihj.17-066

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

An optimal hydration volume (HV) that prevents contrast-induced acute kidney injury (CI-AKI) in patients with renal insufficiency and heart failure (HF) at a high risk of worsening I-IF (WHF) has not been determined. We aimed to determine a safe HV that prevents CI-AKI and WHF following coronary angiography (CAG) or percutaneous coronary intervention (PCI) in patients with renal insufficiency and HE We recruited 1,307 patients with renal insufficiency and HF and investigated the relationships between the peri-procedural HV/weight (HV/W) ratio, and the risks of CI-AKI and WHF following CAG or PCI. Higher HV/W quartiles were associated with higher CI-AKI rates (Q1: 6.2%, Q2: 9.1%, Q3: 12.5%, and Q4: 18.7%; P < 0.001) and a greater likelihood of WHF (Q1: 2.2%, Q2: 2.7%, Q3: 4.9%, and Q4: 11.7%; P < 0.001). The multivariate analyses indicated that excessively high HV/W ratios were associated with moderately increased risks of CI-AM (Q4 versus Q1: adjusted odds ratio [OR] 2.16, 95% confidence interval [CI] 1.17-4.00) and WHF (Q4 versus Q1: adjusted OR 3.09. 95% CI 1.21-7.88). The multivariate Cox regression analysis indicated that a higher HV/W ratio was associated with significantly increased long-term mortality (Q2 versus Q1: adjusted hazard ratio [FIR] 2.36; Q3 versus Q1: adjusted HR 2.85; Q4 versus Q1: adjusted HR 2.94; all P < 0.05). In conclusion, an excessively high HV/W might be associated with a moderately increased risk of CI-AKI, WHF, and long-term mortality in patients with renal insufficiency and HF.

引用

页码：247 / 254

页数：8