Temporal trends of acute kidney injury in patients undergoing percutaneous coronary intervention over a span of 12 years

Background

Acute kidney injury (AKI) is a known complication following percutaneous coronary intervention (PCI), and is associated with higher rates of complications. We sought to determine the potential impact of temporal changes on the rates of AKI over time, as well as possible determinants of risk.

Methods

From a large prospective registry of patients undergoing PCI at Rabin medical center, 20,032 consecutive patients were assessed at two time periods: 2006-2012 and 2012-2018. Of these, included were cases for which data existed regarding change in creatinine levels from baseline to 48 hours after PCI. AKI was defined according to two methods- a relative elevation of >=25% in serum creatinine or an absolute elevation of >=0.5 mg/dL in serum creatinine at 48 hours. We assessed temporal trends of rates of AKI, as well as factors associated with risk of AKI.

Results

15,153 patients were available for final analysis, 7,913 in the first period and 7,240 in the second. Mean age was 65.0y and 66.0y (p<0.01) and baseline creatinine was 1.08 mg/dL and 1.15 mg/dL respectively (p<0.01). 49% of the patients in the first period had diabetes, and 47% in the successive period (p=0.34, table 1).

AKI according to 25% relative rise in serum creatinine was documented in 11.1% in the early period and in 7.3% of the patients in the late period, p

Conclusions

We have witnessed an improvement in the rates of post-PCI AKI over time. Further research is warranted, to further reduce peri-procedural AKI.