Among patients undergoing proximal protected carotid artery stenting, acute kidney injury is common and appears to be related to certain clinical and procedural features, researchers reported.
The researchers analyzed 456 patients undergoing proximal protected CAS to determine frequency of and predictors for acute kidney injury after the procedure.
Acute kidney injury was defined as a serum creatinine increase of at least 0.3 mg/dL or a serum creatinine increase of at least 1.5-fold from baseline within 48 hours of the procedure.
Acute kidney injury occurred in 34% of patients, Armando Pucciarelli, MD, from the division of invasive cardiology at Clinica Montevergine, Mercogliano, Italy, and colleagues found.
Compared with those who did not have acute kidney injury, those who had acute kidney injury were more likely to have hypertension, diabetes, dyslipidemia, anemia and reduced renal function at baseline (P .02 for all), according to the researchers.
The acute kidney injury group also had higher ratio of contrast volume to creatinine clearance (2.4 vs. 2.08; P = .01), lower postprocedural mean arterial pressure (94.3 vs. 996; P = .003) and more frequent drop of at least 50 mm Hg in systolic BP (23.9% vs. 14.3%; P = .01) compared with the non-injury group.
When Pucciarelli and colleagues conducted a multivariate analysis, they found the following were independent predictors of acute kidney injury: drop of at least 50 mm Hg in systolic BP (OR = 1.97; 95% CI, 1.17-3.32), diabetes (OR = 1.64; 95% CI, 1.06-2.53) and dyslipidemia (OR = 1.77; 95% CI, 1.01-3.09).
“This study demonstrates that the occurrence of [acute kidney injury] after proximal protected CAS is a frequent postprocedural complication that is independently predicted by a systolic pressure postprocedural pressure drop > 50 mm Hg as well as by the presence of diabetes and/or dyslipidemia,” the researchers wrote. “The study’s finding should be considered [hypothesis-generating] to design a clinical trial.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.