Atrial Fibrillation and Chronic Kidney Disease-A Risky Combination for Post-Contrast Acute Kidney Injury.
Lukasz KuzmaAnna Tomaszuk-KazberukAnna KuraszMałgorzata Zalewska-AdamiecHanna Bachórzewska-GajewskaSławomir DobrzyckiMarlena KwiatkowskaMalyszko JolantaPublished in: Journal of clinical medicine (2021)
Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (-) 3.04%) and without CKD (CKD (-)/AF (+) 2.32% vs. CKD (-)/AF (-) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications.
Keyphrases
- atrial fibrillation
- chronic kidney disease
- end stage renal disease
- acute kidney injury
- coronary artery disease
- oral anticoagulants
- catheter ablation
- left atrial
- left atrial appendage
- direct oral anticoagulants
- percutaneous coronary intervention
- heart failure
- cardiac surgery
- coronary artery
- peritoneal dialysis
- newly diagnosed
- risk factors
- computed tomography
- magnetic resonance imaging
- ejection fraction
- depressive symptoms
- intensive care unit
- optical coherence tomography
- left ventricular
- coronary artery bypass grafting
- study protocol
- open label
- aortic valve
- cardiovascular events
- mitral valve