Acute Kidney Injury Requiring Dialysis Following Percutaneous Coronary Intervention: Insights From the PROGRESS-COMPLICATIONS Registry
ABSTRACT
Background
Acute kidney injury (AKI) requiring dialysis is a potentially life-threatening complication of percutaneous coronary intervention (PCI).
Aims
To assess the clinical and procedural characteristics and the outcomes of patients with AKI requiring dialysis after PCI.
Methods
We examined the clinical, procedural characteristics and outcomes of AKI requiring dialysis after PCI from a contemporary PCI complication registry (NCT05100940).
Results
Between 2016 and 2023, dialysis was required in 119 of 18,691 PCI patients (0.6%). Mean patient age was 71 ± 11 years, and 58.8% were men, with a high prevalence of diabetes mellitus (38.7%), chronic kidney disease (73.9%), hypertension (84.0%), heart failure (67.8%), and prior myocardial infarction (54.0%). The median baseline creatinine was 1.6 (interquartile range 1.3–2.5) mg/dL. The indication for PCI was an acute coronary syndrome in most patients (94.9%); 28 (23.5%) had preprocedural cardiac arrest (CA) and 14 (11.7%) had cardiogenic shock (CS). The most common target vessel was the left anterior descending artery (44.2%). Bifurcation lesions (37.0%), and moderate/severe calcification (53.5%) were common. Total median contrast volume was 130 (88–200) mL. Median length of hospital stay was 11 days (7–17 days). Technical success was 73.9%. In hospital mortality occurred in 48.7%, hypotension in 43.7%, and major bleeding in 30.3%. During a median follow-up of 35 (9–900) days, patients with AKI requiring dialysis had high incidence of major adverse cardiovascular events (MACE) (63.6%), driven by high mortality (62.1%).
Conclusions
AKI requiring dialysis after PCI occurred in 0.6% of patients and was associated with high in-hospital and follow-up mortality and MACE.
