Journal Home > Volume 1 , Issue 2
Medicine Advances 2023, 1(2): 123-132 https://doi.org/10.1002/med4.20
Original Article | Open Access | Issue | Published: 20 June 2023

Trends in incidence and mortality of acute kidney disease following coronary angiography in Chinese population: 2008–2017

Show Author's Information Qiang Li1,2,  Haozhang Huang1,2,  Weihua Chen3,  Shanshan Shi3,  Xiaozhao Lu1,2,  Wenguang Lai1,2,  Guoxiao Liang1,2,  Jielan Wu1,2,  Jiyan Chen1,2,  Jin Liu1,2,  Shiqun Chen1,2 ( ),  Amanda Y. Wang4,5,6( ),  Yong Liu1,2 ( )
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences, Guangzhou, China
Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
Department of Cardiology, Longyan First Hospital Affiliated with Fujian Medical University, Longyan, China
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
Renal and Metabolic Division, George Institute for Global Health, Newtown, New South Wales, Australia
Department of Renal Medicine, Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia
Keywords:
mortality, acute kidney disease, coronary angiography, trend
Cite this article:
Li Q, Huang H, Chen W, et al. Trends in incidence and mortality of acute kidney disease following coronary angiography in Chinese population: 2008–2017. Medicine Advances, 2023, 1(2): 123-132. https://doi.org/10.1002/med4.20
Download citation
EndNote(RIS)
BibTeX

311

Views

19

Downloads

Citations

0

Crossref

N/A

WoS

N/A

Scopus

N/A

CSCD

Abstract Full text About this article
Background

Acute kidney disease (AKD) has received increasing attention owing to its poor prognosis. However, few studies have investigated the trends in AKD incidence and prognosis among patients undergoing coronary angiography (CAG). Therefore, this study was designed to explore trends in the incidence and mortality of AKD following CAG in China.

Methods

We enrolled patients undergoing CAG using data of the Cardiorenal Improvement (CIN) cohort registry of Guangdong Provincial People's Hospital. Univariate and multivariate logistic regression analyses were applied to examine the incidence of AKD from 2008 to 2017. Mortality rates are presented as deaths per 1000 person‐years and were evaluated in univariate and multivariate Cox regression analyses.

Results

A total of 9665 patients (mean age: 61.6 ± 9.6 years, 40% women) were enrolled in the final analysis. From 2008 to 2017, the overall incidence and mortality of AKD were 19% and 323.0 per 1000 person‐years, respectively. The incidence of AKD decreased from 25% to 13% during 2008–2017 (adjusted odds ratio, 0.40; 95% confidence interval [CI], 0.31–0.51; p < 0.01; p for trend <0.01). However, the mortality of AKD increased significantly from 138.2 to 544.1 per 1000 person‐years (adjusted hazard ratio, 2.85; 95% CI, 1.20–6.73; p = 0.02, p for trend = 0.02). The above trends were observed consistently in patients stratified by sex and age.

Conclusions

Our findings suggest a significant decrease in incidence and an increase in mortality of AKD following CAG from 2008 to 2017 in China. We advocate for more proactive measures to prevent AKD and improve the prognosis of patients with AKD.


menu
Abstract
Full text
Outline
About this article

Trends in incidence and mortality of acute kidney disease following coronary angiography in Chinese population: 2008–2017

Show Author's information Qiang Li1,2, Haozhang Huang1,2, Weihua Chen3, Shanshan Shi3, Xiaozhao Lu1,2, Wenguang Lai1,2, Guoxiao Liang1,2, Jielan Wu1,2, Jiyan Chen1,2, Jin Liu1,2, Shiqun Chen1,2 ( ), Amanda Y. Wang4,5,6( ), Yong Liu1,2 ( )
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences, Guangzhou, China
Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
Department of Cardiology, Longyan First Hospital Affiliated with Fujian Medical University, Longyan, China
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
Renal and Metabolic Division, George Institute for Global Health, Newtown, New South Wales, Australia
Department of Renal Medicine, Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia

Abstract

Background

Acute kidney disease (AKD) has received increasing attention owing to its poor prognosis. However, few studies have investigated the trends in AKD incidence and prognosis among patients undergoing coronary angiography (CAG). Therefore, this study was designed to explore trends in the incidence and mortality of AKD following CAG in China.

Methods

We enrolled patients undergoing CAG using data of the Cardiorenal Improvement (CIN) cohort registry of Guangdong Provincial People's Hospital. Univariate and multivariate logistic regression analyses were applied to examine the incidence of AKD from 2008 to 2017. Mortality rates are presented as deaths per 1000 person‐years and were evaluated in univariate and multivariate Cox regression analyses.

Results

A total of 9665 patients (mean age: 61.6 ± 9.6 years, 40% women) were enrolled in the final analysis. From 2008 to 2017, the overall incidence and mortality of AKD were 19% and 323.0 per 1000 person‐years, respectively. The incidence of AKD decreased from 25% to 13% during 2008–2017 (adjusted odds ratio, 0.40; 95% confidence interval [CI], 0.31–0.51; p < 0.01; p for trend <0.01). However, the mortality of AKD increased significantly from 138.2 to 544.1 per 1000 person‐years (adjusted hazard ratio, 2.85; 95% CI, 1.20–6.73; p = 0.02, p for trend = 0.02). The above trends were observed consistently in patients stratified by sex and age.

Conclusions

Our findings suggest a significant decrease in incidence and an increase in mortality of AKD following CAG from 2008 to 2017 in China. We advocate for more proactive measures to prevent AKD and improve the prognosis of patients with AKD.

Keywords: mortality, acute kidney disease, coronary angiography, trend

References(22)

[1]

Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179–84. https://doi.org/10.1159/000339789
DOI Google Scholar
[2]

James MT, Levey AS, Tonelli M, Tan Z, Barry R, Pannu N, et al. Incidence and prognosis of acute kidney diseases and disorders using an integrated approach to laboratory measurements in a universal health care system. JAMA Netw Open. 2019;2(4):e191795. https://doi.org/10.1001/jamanetworkopen.2019.1795
DOI Google Scholar
[3]

Tonon M, Rosi S, Gambino CG, Piano S, Calvino V, Romano A, et al. Natural history of acute kidney disease in patients with cirrhosis. J Hepatol. 2021;74(3):578–83. https://doi.org/10.1016/j.jhep.2020.08.037
DOI Google Scholar
[4]

Xiao YQ, Cheng W, Wu X, Yan P, Feng LX, Zhang NY, et al. Novel risk models to predict acute kidney disease and its outcomes in a Chinese hospitalized population with acute kidney injury. Sci Rep. 2020;10(1):15636. https://doi.org/10.1038/s41598-020-72651-x
DOI Google Scholar
[5]

Mima A, Tansho K, Nagahara D, Tsubaki K. Incidence of acute kidney disease after receiving hematopoietic stem cell transplantation: a single‐center retrospective study. PeerJ. 2019;7:e6467. https://doi.org/10.7717/peerj.6467
DOI Google Scholar
[6]

Chen YT, Jenq CC, Hsu CK, Yu YC, Chang CH, Fan PC, et al. Acute kidney disease and acute kidney injury biomarkers in coronary care unit patients. BMC Nephrol. 2020;21(1):207. https://doi.org/10.1186/s12882-020-01872-z
DOI Google Scholar
[7]

Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Acute kidney disease and renal recovery: consensus report of the acute disease quality initiative (ADQI) 16 workgroup. Nat Rev Nephrol. 2017;13(4):241–57. https://doi.org/10.1038/nrneph.2017.2
DOI Google Scholar
[8]

Jneid H, Anderson JL, Wright RS, Adams CD, Bridges CR, Casey DE, Jr., et al. ACCF/AHA focused update of the guideline for the management of patients with unstable angina/non‐ST‐elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 focused update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2012;60(7):645–81. https://doi.org/10.1016/j.jacc.2012.06.004
DOI Google Scholar
[9]

Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST‐elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST‐elevation myocardial infarction. J Am Coll Cardiol. 2015;67(10):1235–50. https://doi.org/10.1016/j.jacc.2015.10.005
DOI Google Scholar
[10]

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med. 1999;130(6):461–70. https://doi.org/10.7326/0003-4819-130-6-199903160-00002
DOI Google Scholar
[11]

Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast‐induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44(7):1393–9. https://doi.org/10.1016/j.jacc.2004.06.068
DOI Google Scholar
[12]

Forni LG, Darmon M, Ostermann M, Oudemans‐van Straaten HM, Pettila V, Prowle JR, et al. Renal recovery after acute kidney injury. Intensive Care Med. 2017;43(6):855–66. https://doi.org/10.1007/s00134-017-4809-x
DOI Google Scholar
[13]

Liu J, Li Q, Lai D, Chen G, Wang B, Liu L, et al. Trends in incidence and long‐term prognosis of acute kidney injury following coronary angiography in Chinese cohort with 11,943 patients from 2013 to 2017: an observational study. BMC Nephrol. 2021;22(1):235. https://doi.org/10.1186/s12882-021-02427-6
DOI Google Scholar
[14]

Brar SS, Aharonian V, Mansukhani P, Moore N, Shen AY, Jorgensen M, et al. Haemodynamic‐guided fluid administration for the prevention of contrast‐induced acute kidney injury: the POSEIDON randomised controlled trial. Lancet. 2014;383(9931):1814–23. https://doi.org/10.1016/S0140-6736(14)60689-9
DOI Google Scholar
[15]

Maioli M, Toso A, Leoncini M, Musilli N, Grippo G, Ronco C, et al. Bioimpedance‐Guided hydration for the prevention of contrast‐induced kidney injury: the HYDRA study. J Am Coll Cardiol. 2018;71(25):2880–9. https://doi.org/10.1016/j.jacc.2018.04.022
DOI Google Scholar
[16]

Qian G, Fu Z, Guo J, Cao F, Chen Y. Prevention of contrast‐induced nephropathy by central venous pressure‐guided fluid administration in chronic kidney disease and congestive heart failure patients. JACC Cardiovasc Interv. 2016;9(1):89–96. https://doi.org/10.1016/j.jcin.2015.09.026
DOI Google Scholar
[17]

Matsuura R, Iwagami M, Moriya H, Ohtake T, Hamasaki Y, Nangaku M, et al. The clinical course of acute kidney disease after cardiac surgery: a retrospective observational study. Sci Rep. 2020;10(1):6490. https://doi.org/10.1038/s41598-020-62981-1
DOI Google Scholar
[18]

Chen WY, Hsiao CH, Chen YC, Ho CH, Wang JJ, Hsing CH, et al. Cisplatin nephrotoxicity might have a sex difference. An analysis based on women's sex hormone changes. J Cancer. 2017;8(19):3939–44. https://doi.org/10.7150/jca.20083
DOI Google Scholar
[19]

Ronco C, Rosner MH. Acute kidney injury and residual renal function. Crit Care. 2012;16(4):144. https://doi.org/10.1186/cc11426
DOI Google Scholar
[20]

Chronopoulos A, Cruz DN, Ronco C. Hospital‐acquired acute kidney injury in the elderly. Nat Rev Nephrol. 2010;6(3):141–9. https://doi.org/10.1038/nrneph.2009.234
DOI Google Scholar
[21]

Neyra JA, Chawla LS. Acute kidney disease to chronic kidney disease. Crit Care Clin. 2021;37(2):453–74. https://doi.org/10.1016/j.ccc.2020.11.013
DOI Google Scholar
[22]

Levey AS, Becker C, Inker LA. Glomerular filtration rate and albuminuria for detection and staging of acute and chronic kidney disease in adults: a systematic review. JAMA. 2015;313(8):837–46. https://doi.org/10.1001/jama.2015.0602
DOI Google Scholar
Publication history
Copyright
Acknowledgements
Rights and permissions

Publication history

Received: 24 February 2023
Accepted: 13 May 2023
Published: 20 June 2023
Issue date: June 2023

Copyright

© 2023 The Authors. Tsinghua University Press.

Acknowledgements

ACKNOWLEDGMENTS

Professor Wang was supported by a grant from the National Heart Foundation Vanguard, Australia. This research was funded and supported by the Guangdong Provincial Science and Technology Project (2020B1111170011 and KJ022021049), and Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention (No. Y0120220151).

Rights and permissions

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

Return