Impact of chronic kidney disease on prognosis of patients with diabetes mellitus treated with percutaneous coronary intervention
Section snippets
Study population
The study is based on patients with diabetes who underwent native-vessel PCI over a 6-year period at a single tertiary care center. Patients treated with PCI for acute myocardial infarction and patients known to have neoplastic disorders were excluded. Data collection and analysis have been described previously.3 Information on 1-year outcomes was obtained from telephone interviews by experienced research nurses. All adverse events were source documented. The study was approved by the
Results
Of 1,575 patients with diabetes treated with PCI, 1,046 (66%) had preserved renal function, 492 (31%) had CKD not requiring dialysis, and 37 (2.3%) were dependent on dialysis.
Compared with patients with preserved renal function (Table 1), those with CKD but not on dialysis were older and more frequently women and had a smaller body surface area and lower left ventricle ejection fractions (p = 0.005 to p <0.0001). In addition, hypertension, advanced congestive heart failure, peripheral arterial
Discussion
In this study, 33% of patients with medically treated diabetes who underwent PCI had CKD. CKD was associated with significantly worse short- and long-term outcomes. Compared with patients with preserved renal function, those with CKD not on dialysis had 5 times higher in-hospital rates of mortality and neurologic complications, 3 times higher rates of pulmonary edema and gastrointestinal bleeding, and a significantly prolonged in-hospital stay. One-year survival rate in patients with CKD was 3
Acknowledgements
The investigators are grateful to Yingbo Na, MSc, for statistical review of this report.
References (18)
- et al.
Diabetes, hemoglobin A(1c), cholesterol, and the risk of moderate CKD in an ambulatory population
Am J Kidney Dis
(2000) - et al.
The impact of renal insufficiency on clinical outcomes in patients undergoing percutaneous coronary interventions
J Am Coll Cardiol
(2002) - et al.
Level of kidney function as a risk factor for atherosclerotic cardiovascular outcomes in the community
J Am Coll Cardiol
(2003) - et al.
Effectiveness of and adverse events after percutaneous coronary intervention in patients with mild versus severe renal failure
Am J Cardiol
(2001) - et al.
Evaluation of long-term survival after successful percutaneous coronary intervention among patients with chronic renal failure
Am J Cardiol
(2001) - et al.
Long-term outcome of dialysis patients in the United States with coronary revascularization procedures
Kidney Int
(1999) - et al.
Acute renal failure after coronary interventionincidence, risk factors, and relationship to mortality
Am J Med
(1997) - et al.
Safety of gadolinium contrast angiography in patients with CKD
J Vasc Surg
(2003) - et al.
Clinical outcome following percutaneous coronary interventions in patients with chronic renal failure
Catheter Cardiovasc Interv
(2002)