A prediction model of contrast-associated acute kidney injury in patients with hypoalbuminemia undergoing coronary angio
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RESEARCH ARTICLE
Open Access
A prediction model of contrast-associated acute kidney injury in patients with hypoalbuminemia undergoing coronary angiography Liwei Liu1,2†, Jin Liu2†, Li Lei1,2†, Bo Wang2†, Guoli Sun2, Zhaodong Guo2, Yibo He2, Feier Song3, Zhubin Lun4, Bowen Liu5, Guanzhong Chen5, Shiqun Chen2, Yongquan Yang2,5, Yong Liu1,2,5* and Jiyan Chen1,2,5*
Abstract Background: Risk stratification is recommended as the key step to prevent contrast-associated acute kidney injury (CA-AKI) among at-risk patients following coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). Patients with hypoalbuminemia are prone to CA-AKI and do not have their own risk stratification tool. Therefore, this study developed and validated a new model for predicting CA-AKI among hypoalbuminemia patients CAG/PCI. Methods: 1272 patients with hypoalbuminemia receiving CAG/PCI were enrolled and randomly allocated (2:1 ratio) into the development cohort (n = 848) and the validation cohort (n = 424). CA-AKI was defined as an increase of ≥0.3 mg/dL or 50% in serum creatinine (SCr) compared to baseline in the 48 to 72 h after CAG/PCI. A prediction model was established with independent predictors according to stepwise logistic regression, showing as a nomogram. The discrimination of the new model was evaluated by the area under the curve (AUC) and was compared to the classic Mehran CA-AKI model. The Hosmer-Lemeshow test was conducted to assess the calibration of our model. Results: Overall, 8.4% (71/848) patients of the development group and 11.2% (48/424) patients of the validation group experienced CA-AKI. A new nomogram included estimated glomerular filtration rate (eGFR), serum albumin (ALB), age and the use of intra-aortic balloon pump (IABP); showed better predictive ability than the Mehran score (C-index 0.756 vs. 0.693, p = 0.02); and had good calibration (Hosmer–Lemeshow test p = 0.187). Conclusions: We developed a simple model for predicting CA-AKI among patients with hypoalbuminemia undergoing CAG/PCI, but our findings need validating externally. Trial registration: http://www.ClinicalTrials.gov NCT01400295, retrospectively registered 21 July 2011. Keywords: Contrast-associated kidney injury, Hypoalbuminemia, Nomogram, Coronary angiography, Percutaneous coronary intervention
* Correspondence: [email protected]; [email protected] † Liwei Liu, Jin Liu, Li Lei and Bo Wang contributed equally to this work. 1 The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this a
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