Problems in the diagnosis of acute kidney injury in patients with ST-segment elevation myocardial infarction

被引:0
作者
Menzorov, M. V. [1 ]
Shutov, A. M. [1 ]
Makeeva, E. R. [1 ]
Serov, V. A. [1 ]
Mikhailova, E. V. [1 ]
Parfenova, E. A. [1 ]
机构
[1] Ulyanovsk State Univ, Fac Med, Dept Therapy & Occupat Dis, Ulyanovsk, Russia
关键词
acute kidney injury; ST-segment elevation acute myocardial infarction; KDIGO guidelines; calculated creatinine; RENAL-FUNCTION; RISK-FACTORS; BIOMARKERS; PROGNOSIS; MORTALITY; FAILURE; URINARY;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim. To estimate the frequency and severity of acute kidney injury (AKI) in patients with ST-segment elevation acute myocardial infarction (STSEAMI), to specify whether the changes in diuresis and serum creatinine levels are equally sensitive diagnostic criteria for AKI, and to define their prognostic value. Subjects and methods. Three hundred and nineteen patients (249 (78%) men and 70 (22%) women; age 58 10 years) with STSEAMI who received thrombolytic therapy (TLT) were examined. The diagnosis of STSEAMI, indications for and contraindications to TLT, evaluation of its efficiency were made in accordance with the All-Russian Scientific Society of Cardiology guidelines (2007). AKI was diagnosed and classified using the KDIGO guidelines (2012). Results. AKI was diagnosed in terms of diuresis, calculated creatinine levels, and creatinine level changes in 107 (34%), 73 (23%), and 68 (22%) patients, respectively. Among the patients with AKI diagnosed in view of diuresis, in-hospital death rates were higher than in those without AKI (X-2=25.46; p<0.001); the similar pattern was seen in patients with AKI diagnosed in terms of calculated creatinine levels (X-2=3.99; p=0.045). Logistic regression analysis indicated that regardless of gender, age, and time interval between onset of clinical manifestation and hospital admission, the in-hospital death rates were associated with the presence of AKI in view of diuresis (relative risk 14; 95% confidence interval, 4.03 to 52.08; p<0.001). Conclusion. The STSEAMI patents receiving TLT exhibited a high rate of AKI. The major problem in the early detection of AKI is associated with difficulties in the differential diagnosis of AKI and chronic kidney disease. AKI diagnosed in view of diuresis is of greater prognostic value for in-hospital mortality than that diagnosed in terms of creatinine levels. The diagnosis of renal dysfunction in view of basal creatinine levels is prognostically important despite the fact that this cannot differentiate AKI from chronic kidney disease in the early stage.
引用
收藏
页码:25 / 29
页数:5
相关论文
共 50 条
  • [21] Smoking and Hypertriglyceridemia Predict ST-Segment Elevation Myocardial Infarction in Kosovo Patients with Acute Myocardial Infarction
    Poniku, Afrim
    Batalli, Arlind
    Shita, Dua
    Rexhaj, Zarife
    Ferati, Arlind
    Leka, Rita
    Bajraktari, Artan
    Abdyli, Genc
    Haliti, Edmond
    Ibrahimi, Pranvera
    Karahoda, Rona
    Elezi, Shpend
    Shatri, Faik
    Bytyci, Ibadete
    Henein, Michael
    Bajraktari, Gani
    CLINICS AND PRACTICE, 2024, 14 (03) : 1149 - 1158
  • [22] Obesity and Acute Kidney Injury in Patients with ST-Elevation Myocardial Infarction
    Kanic, Vojko
    Suran, David
    Kompara, Gregor
    JOURNAL OF CLINICAL MEDICINE, 2023, 12 (23)
  • [23] Cardiovascular risk factors in patients with ST-segment elevation myocardial infarction
    Shang, Chen
    Hernandez Veliz, Damaris
    Ferrer Arrocha, Marlene
    Alonso Martinez, Maylin, I
    Perez Assef, Hector
    CORSALUD, 2020, 12 (01): : 31 - 37
  • [24] Risk Factors of Ischemia Reperfusion Injury After PCI in Patients with Acute ST-Segment Elevation Myocardial Infarction and its Influence on Prognosis
    Zhang, Li
    Wang, Lingqing
    Tao, Luyuan
    Chen, Changgong
    Ren, Shijia
    Zhang, Youyou
    FRONTIERS IN SURGERY, 2022, 9
  • [25] Impact of left ventricular hypertrophy on myocardial injury in patients with ST-segment elevation myocardial infarction
    Thomas Stiermaier
    Janine Pöss
    Charlotte Eitel
    Suzanne de Waha
    Georg Fuernau
    Steffen Desch
    Holger Thiele
    Ingo Eitel
    Clinical Research in Cardiology, 2018, 107 : 1013 - 1020
  • [26] Impact of left ventricular hypertrophy on myocardial injury in patients with ST-segment elevation myocardial infarction
    Stiermaier, Thomas
    Poess, Janine
    Eitel, Charlotte
    de Waha, Suzanne
    Fuernau, Georg
    Desch, Steffen
    Thiele, Holger
    Eitel, Ingo
    CLINICAL RESEARCH IN CARDIOLOGY, 2018, 107 (11) : 1013 - 1020
  • [27] Analysis of Biomarkers for Risk of Acute Kidney Injury After Primary Angioplasty for Acute ST-Segment Elevation Myocardial Infarction: Results of the HORIZONS-AMI Trial
    Guerchicoff, Alejandra
    Stone, Gregg W.
    Mehran, Roxana
    Xu, Ke
    Nichols, Dru
    Claessen, Bimmer E.
    Guagliumi, Giulio
    Witzenbichler, Bernhard
    Henriques, Jose P. S.
    Dangas, George D.
    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2015, 85 (03) : 335 - 342
  • [28] Season and myocardial injury in patients with ST-segment elevation myocardial infarction: A cardiac magnetic resonance imaging study
    Park, Ik Hyun
    Jang, Woo Jin
    Cho, Hyun Kyu
    Oh, Ju Hyeon
    Chun, Woo Jung
    Park, Yong Hwan
    Lee, Mirae
    Song, Young Bin
    Hahn, Joo-Yong
    Choi, Seung-Hyuk
    Lee, Sang-Chol
    Gwon, Hyeon-Cheol
    Choe, Yeon Hyeon
    PLOS ONE, 2019, 14 (02):
  • [29] Anticoagulation for ST-Segment Elevation Myocardial Infarction
    Eikelboom, John W.
    Weitz, Jeffrey I.
    CIRCULATION, 2009, 119 (09) : 1186 - 1188
  • [30] Sex differences in the association between d-dimer and the incidence of acute kidney injury in patients admitted with ST-segment elevation myocardial infarction: a retrospective observational study
    Zhou, Xi
    Wang, Dingzhou
    Jin, Youkai
    Gong, Mengge
    Lin, Qingcheng
    He, Yanlei
    Huang, Weijian
    Shan, Peiren
    Liang, Dongjie
    INTERNAL AND EMERGENCY MEDICINE, 2024, 19 (01) : 91 - 98