Evaluating the Association between Hyperuricemia and Contrast InducedAcute Kidney Injury in Patients with Acute ST-Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Abdallah E, Mosbah O, El-Shistawy S, Khalifa G, Badr M, Amin AA
2016 SM Journal of Nephrology and Therapeutics  
Contrast-Induced Acute Kidney Injury (CI-AKI) is the third most common cause of in-hospital acute kidney injury (AKI) and accounts for 10% of total cases [1] . CI-AKI continues to be one of the most common major adverse side effect of cardiac catheterization, and is associated with short-and long-term morbidity and mortality [2, 3] . This is particularly true in the population presenting with acute ST-Elevation Myocardial Infarction (STEMI). A recent study evaluating the epidemiology of CI-AKI
more » ... n over 8000 patients undergoing PCI found that CI-AKI occurred in 12% of STEMI, which was significantly higher compared with patients undergoing non-emergent catheterization (9.2% in unstable angina and NSTEMI patients and 4.5% undergoing elective PCI). Even in patients with baseline Glomerular Filtration Rate (GFR)>60, the incidence of CI-AKI in the STEMI patients was 9.2% [4] . Such a high incidence of this complication invokes the need to define measures to decrease the occurrence of CI-AKI in patients presenting with STEMI. In addition to prophylactic intravenous volume expansion with isotonic crystalloid solution, few prophylactic strategies for CI-AKI are clearly effective [5] . The most important step in reducing the risk of CI-AKI is identifying at-risk patients as old age, Chronic Kidney Disease (CKD), Diabetes Mellitus (DM), hypertension, metabolic syndrome, hypovolemia, Congestive Heart Failure (CHF), an Ejection Fraction (EF) of less than 40%, hypotension, and Intra-Aortic Balloon Counterpulsation (IABP) use. Procedure-related risk factors are as urgent versus elective, arterial versus venous contrast. Contrast-related risk factors are as contrast volume, contrast characteristics, including osmolarity, ionicity, molecular structure, and viscosity. The single most important patient-related risk factor is preexisting CKD, even more so than DM [6] . Patients with CKD in the setting of DM
doi:10.36876/smjnt.1003 fatcat:mgiuywul7fgdzadkvjtfo2gncy