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Kidney Week

Abstract: SA-OR007

Renin-Angiotensin-Aldosterone System Blockade Is Associated with Higher Risk of Contrast-Induced AKI in Patients with Diabetes: A Multicenter Propensity Score-Matched Study

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Author

  • Ma, Mengqing, Sir Run Run Hospital, Nanjing, China
Background

CIAKI is a relatively common complication after treatment of coronary angiography (CAG) and percutaneous coronary intervention (PCI). The role of ACEIs or ARBs on CIAKI is controversial.

Methods

A retrospective, multi-center design with propensity score matching (PSM) was used to evaluate the effect of ACEIs/ARBs on the occurrence of CIAKI in diabetic patients undergoing CAG and PCI. The primary endpoint CIAKI was defined as an increased serum creatinine level of ≥ 25% or 44 μmol/l (0.5mg/dl) over the baseline level within 72 hours after contrast agent exposed.

Results

A total of 2240 patients from four centers met the inclusion criteria. On the basis of PSM, 704 patients with ACEIs/ARBs were successfully matched to the control group. The incidence of CIAKI in the ACEIs/ARBs group was significantly higher than that in the control group (26.6%vs.16.2%, P< 0.001), no matter which kind of medicine was used in subgroups. In-hospital endpoints, patients with CIAKI had a higher risk of worsening heart failure (2.3% vs. 1.0%, P= 0.068). However, patients in the control group had an increased risk of overall adverse cardiovascular events (death, myocardial infarction, worsening heart failure, stroke) after PCI (3.8% vs. 1.8%, P= 0.034).

Conclusion

The ACEI/ARB was associated with an increased risk of CIAKI in patients with diabetes, but beneficial for early cardiovascular outcomes.