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首页> 美国卫生研究院文献>other >Relationship Between the Urine Flow Rate and Risk of Contrast-Induced Nephropathy After Emergent Percutaneous Coronary Intervention
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Relationship Between the Urine Flow Rate and Risk of Contrast-Induced Nephropathy After Emergent Percutaneous Coronary Intervention

机译：急诊经皮冠状动脉介入术后尿流率与造影剂肾病风险的关系

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A low urine flow rate is a marker of acute kidney injury. However, it is unclear whether a high urine flow rate is associated with a reduced risk of contrast-induced nephropathy (CIN) in high-risk patients.We conducted this study to evaluate the predictive value of the urine flow rate for the risk of CIN following emergent percutaneous coronary intervention (PCI).We prospectively examined 308 patients undergoing emergent PCI who provided consent. The predictive value of the 24-hour postprocedural urine flow rate, adjusted by weight (UR/W, mL/kg/h) and divided into quartiles, for the risk of CIN was assessed using multivariate logistic regression analysis.The cumulative incidence of CIN was 24.4%. In particular, CIN was observed in 29.5%, 19.5%, 16.7%, and 32.0% of cases in the UR/W quartile (Q)-1 (≤0.94 mL/kg/h), Q2 (0.94–1.30 mL/kg/h), Q3 (1.30–1.71 mL/kg/h), and Q4 (≥1.71 mL/kg/h), respectively. Moreover, in-hospital death was noted in 7.7%, 3.9%, 5.1%, and 5.3% of patients in Q1, Q2, Q3, and Q4, respectively. After adjusting for potential confounding predictors, multivariate analysis indicated that compared with the moderate urine flow rate quartiles (Q2 + Q3), a high urine flow rate (Q4) (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.27–5.68; P = 0.010) and low urine flow rate (Q1) (OR, 2.23; 95% CI, 1.03–4.82; P = 0.041) were significantly associated with an increased risk of CIN. Moreover, a moderate urine flow rate (0.94–1.71 mL/kg/h) was significantly associated with a decreased risk of mortality.Our data suggest that higher and lower urine flow rates were significantly associated with an increased risk of CIN after emergent PCI, and a moderate urine flow rate (0.94–1.71 mL/kg/h) may be associated with a decreased risk of CIN with a good long-term prognosis after emergent PCI.
机译：尿流率低是急性肾损伤的标志。然而，目前尚不清楚高风险患者中高尿流率是否与降低造影剂肾病（CIN）的风险有关。我们进行了这项研究，以评估尿流率对CIN风险的预测价值在急诊经皮冠状动脉介入治疗（PCI）之后。我们对308例接受急诊PCI的患者表示同意。使用多元logistic回归分析评估按体重（UR / W，mL / kg / h）调整并分为四分位数的24小时术后尿流率对CIN风险的预测值。是24.4％。特别是，在UR / W四分位数（Q）-1（≤0.94mL / kg / h），Q2（0.94-1.30 mL / kg）中，分别有29.5％，19.5％，16.7％和32.0％的患者观察到CIN / h），Q3（1.30-1.71mL / kg / h）和Q4（≥1.71mLmL/ kg / h）。此外，在第一季度，第二季度，第三季度和第四季度，分别有7.7％，3.9％，5.1％和5.3％的患者住院死亡。在对潜在的混杂预测因素进行调整后，多因素分析表明，与中等尿流率四分位数（Q2 + Q3）相比，尿流率高（Q4）（赔率[OR]为2.69； 95％置信区间[CI]， 1.27–5.68； P = 0.010）和低尿流率（Q1）（OR，2.23； 95％CI，1.03-4.82； P = 0.041）与CIN风险增加显着相关。此外，适度的尿流率（0.94–1.71 mL / kg / h）与降低的死亡风险显着相关。我们的数据表明，较高和较低的尿流率与PCI发生后CIN风险增加显着相关，适度的尿流速（0.94–1.71 mL / kg / h）可能与降低的CIN风险有关，PCI术后长期预后良好。

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