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Abstract: PO0017

Racial Differences in AKI Following Percutaneous Coronary Intervention

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Lunyera, Joseph, Duke University School of Medicine, Durham, North Carolina, United States
  • Clare, Robert M., Duke Clinical Research Institute, Durham, North Carolina, United States
  • Chiswell, Karen, Duke Clinical Research Institute, Durham, North Carolina, United States
  • Scialla, Julia J., University of Virginia School of Medicine, Charlottesville, Virginia, United States
  • Pun, Patrick H., Duke Clinical Research Institute, Durham, North Carolina, United States
  • Thomas, Kevin L., Duke Clinical Research Institute, Durham, North Carolina, United States
  • Starks, Monique, Duke Clinical Research Institute, Durham, North Carolina, United States
  • Diamantidis, Clarissa Jonas, Duke University School of Medicine, Durham, North Carolina, United States
Background

Percutaneous coronary intervention (PCI) is a risk factor for AKI, but few studies have quantified racial differences in AKI incidence following PCI.

Methods

We examined the association of self-reported race – black, white, and other – and baseline eGFR with AKI incidence among patients captured in the Duke Databank for Cardiovascular Disease (DDCD) who underwent PCI at Duke between January 1, 2003 and December 31, 2013. AKI was defined as ≥ 1.5-fold increase in serum creatinine from outpatient reference value before PCI to the peak value within 7 days post-PCI or a 0.3 mg/dl increase from the reference value within 48 hours. We used logistic regression adjusted for demographics, comorbidities, predisposing medications (NSAIDS, RAAS inhibitors, diuretics), PCI indication (presenting with vs without acute coronary syndrome), peri-procedural prophylaxis with IV fluids and n-acetylcysteine, urgency of PCI and BP at time of PCI.

Results

Of 9422 patients (median age 63y [IQR 54 to 72]; 33% female; 75% white, 20% black, 5% other race), 9% developed AKI: 14% of blacks, 8% of whites, 10% in other race groups. After adjustment, black race was associated with greater likelihood of AKI: odds ratio (OR) 1.80 in black (vs white) patients (95% confidence interval (CI) 1.49 to 2.18. Compared to white, other race was not associated with AKI: OR 1.31, 95% CI 0.91 to 1.87. Low baseline eGFR was associated with graded, higher likelihood of AKI: p for trend <0.001. There was no interaction between race and baseline eGFR.

Conclusion

Black patients had nearly twice the likelihood for AKI following PCI than whites despite adjustment for baseline kidney function, prophylaxis and procedural characteristics. Future investigations should identify other factors that predispose black individuals to disparate AKI risk following PCI.

Funding

  • Private Foundation Support