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ACUTE KIDNEY INJURY AT PATIENTS WITH ST-ELEVATED MYOCARDIAL INFARCTION

https://doi.org/10.24884/1561-6274-2012-16-1-40-44

Abstract

AIM. To estimate frequency and intensity of acute kidney injury (AKI) by RIFLE and AKIN criteria at patients with ST-elevated myocardial infarction (STEMI), to specify connection between AKI and mortality and effectivness of thrombolytic therapy (TLT). PATIENTS AND METНODS. 165 patients (134 men and 31 women, average age 56,6±10,43 years) with STEMI, who were performed TLT. AKI was diagnosed and classified by RIFLE and AKIN criteria by creatinine (RIFLECr, AKINCr) and diuresis (RIFLEOU, AKINOU). RESULTS. TLT was effective at 115 patients (70%). According to RIFLECr AKI was diagnosed at 87 patients (53%), by AKINCr criteria – at 101 patients (61%). According to RIFLEOU and AKINOU criteria AKI was noticed at 56 patients (34%). 9 patients (5%) died. Logistic regression analysis showed that AKI about RIFLEOU and AKINOU was time and age independent from the beginning of characteristic clinical picture till hospitalization associated with intrahospital mortality (hazard ratio 17,1; 95% CI 2,01 – 146.46; p=0,006). CONCLUSION. More then half of patients with STEMI have AKI by RIFLECr and AKINCr criteria. AKI frequency by RIFLEOU and AKINOU is twice as little in comparison with evaluation by AKINCr and 40% fewer in comparison with evaluation by RIFLECr, AKI presence is associated with effect absence from thrombolytic therapy and increased intrahospital mortality.

About the Authors

M. V. Menzorov
Ульяновский государственный университет
Russian Federation


A. M. Shutov
Ульяновский государственный университет
Russian Federation


V. A. Serov
Ульяновский государственный университет
Russian Federation


E. V. Michajlova
Ульяновский государственный университет
Russian Federation


T. V. Klimova
Центральная городская клиническая больница г.Ульяновска
Russian Federation


E. A. Astapenko
Ульяновский государственный университет
Russian Federation


References

1. Leblanc M, Kellum JA, Gibney RT et al. Risk factors for acute renal failure: inherent and modifiable risks. Curr Opin Crit Care 2005; 11: 533-536

2. Смирнов АВ, Каюков ИГ, Добронравов ВА и др. Острое повреждение почек – новое понятие в нефрологии. Клиническая нефрология 2009; 1: 11-15

3. Национальные рекомендации по диагностике и лечению больных острым инфарктом миокарда с подъемом сегмента ST ЭКГ. Кардиоваскулярная терапия и профилактика 2007;6(8), Приложение 1

4. Mehran R, Aymong ED, Nikolsky E 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: 1393–1399

5. Goldberg A, Hammerman H, Petcherski S et al. In-hospital and 1-year mortality of patients who develop worsening renal function following acute ST-elevation myocardial infarction. Am Heart J 2005; 150: 330-337

6. Marenzi G, Assanelli E, Campodonico J et al. Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission. Crit Care Med 2010; 38: 438-444

7. Parikh CR, Coca SG, Wang Y et al. Long-term Prognosis of Acute Kidney Injury After Acute Myocardial Infarction. Arch Intern Med 2008; 168: 987-995

8. Bellomo R, Ronco C, Kellum JA et al. Acute renal failure– definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004; 8: 204–212

9. Mehta RL, Kellum JA, Shah S et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11: 31

10. Bagshaw SM, George C, Bellomo R. A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients. Nephrol Dial Transplant 2008; 23: 1569–1574

11. Englberger L, Suri RM, Li Z et al. Clinical accuracy of RIFLE and Acute Kidney Injury Network (AKIN) criteria for acute kidney injury in patients undergoing cardiac surgery. Crit Care 2011; 15:16

12. Joannidis M, Metnitz B, Bauer P et al. Acute kidney injury in critically ill patients classified by AKIN versus RIFLE using the SAPS 3 database. Intensive Care Med 2009; 35:1692-1702

13. Chang CH, Lin CY, Tian YC et al. Acute kidney injury classification: comparison of AKIN and RIFLE criteria. Shock 2010; 33:247-252

14. Macedo E, Malhotra R, Claure-Del Granado R et al. Defining urine output criterion for acute kidney injury in critically ill patients. Nephrol Dial Transplant 2011; 26: 509–515

15. Chenoweth CE, Saint S. Urinary tract infections. Infectious Disease Clinics of North America 2011; 25: 103-115

16. Mahesh B, Yim B, Robson D et al. Does furosemide prevent renal dysfunction in high-risk cardiac surgical patients? Results of a double-blinded prospective randomised trial. Eur J Cardiothorac Surg 2008; 33: 370-376

17. Siew ED, Matheny ME, Ikizler TA et al. Commonly used surrogates for baseline renal function affect the classification and prognosis of acute kidney injury. Kidney Int 2010; 77: 536–542

18. Basu G, Chrispal A, Boorugu H, Kango G et al. Acute kidney injury in tropical acute febrile illness in a tertiary care centre–RIFLE criteria validation. Nephrol Dial Transplant 2011; 26: 524–531

19. Шутов АМ, Курзина ЕВ, Серов ВА, Ивашкина ТН. Митральная регургитация у больных с хронической сердечной недостаточностью ассоциирована со снижением функционального состояния почек. Нефрология 2008;12(1):19-23

20. Koyner JL, Vaidya VS, Bennett MR et al. Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury. Clin J Am Soc Nephrol 2010; 5: 2154-2165

21. Self WH, Barrett TW. Novel biomarkers: help or hindrance to patient care in the emergency department? Ann Emerg Med 2010; 56: 60-61

22. Cruz DN, Cal M, Garzotto F et al. Plasma neutrophil gelatinase-associated lipocalin is an early biomarker for acute kidney injury in an adult ICU population. Intensive Care Med 2010; 36: 444–451

23. Shavit L, Dolgoker I, Ivgi H et al. Neutrophil GelatinaseAssociated Lipocalin as a Predictor of Complications and Mortality in Patients Undergoing Non-Cardiac Major Surgery. Kidney Blood Press Res 2011; 34: 116-124

24. Biesen WV, Massenhove JV, Hoste E et al. Defining acute kidney injury: playing hide-and-seek with the unknown man? Nephrol Dial Transplant 2011; 26: 399–401


Review

For citations:


Menzorov M.V., Shutov A.M., Serov V.A., Michajlova E.V., Klimova T.V., Astapenko E.A. ACUTE KIDNEY INJURY AT PATIENTS WITH ST-ELEVATED MYOCARDIAL INFARCTION. Nephrology (Saint-Petersburg). 2012;16(1):40-44. (In Russ.) https://doi.org/10.24884/1561-6274-2012-16-1-40-44

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ISSN 1561-6274 (Print)
ISSN 2541-9439 (Online)