Acute renal failure requiring dialysis after percutaneous coronary interventions

Catheter Cardiovasc Interv. 2001 Apr;52(4):409-16. doi: 10.1002/ccd.1093.


Acute renal failure requiring dialysis is a rare but serious complication after percutaneous coronary interventions (PCI), associated with high in-hospital mortality and poor long-term survival. We have analyzed the incidence, resource utilization, short- and long-term outcomes, and predictors of dialysis after percutaneous coronary interventions. We studied 51 consecutive patients who were not on dialysis on admission and developed acute renal failure that required in-hospital dialysis after PCI in comparison to the 7,690 patients who did not require dialysis after PCI. Patients who required dialysis were older, with a higher incidence of hypertension, diabetes, prior bypass surgery, chronic renal failure, and a significantly lower left ventricular ejection fraction. Despite similar angiographic success, these patients had a higher incidence of in-hospital mortality (27.5% vs. 1.0%, P < 0.0001), non-Q-wave myocardial infarction (45.7% vs. 14.6%, P < 0.0001), vascular and bleeding complications, and longer hospitalization. At 1-year follow-up, mortality (54.5% vs. 6.4%, P < 0.0001), myocardial infarction (4.5% vs. 1.6%, P = 0.006), and event-free survival (38.6% vs. 72.0%, P < 0.0001) were significantly worse in patients who required dialysis compared to patients who did not. Multivariate analysis revealed in-hospital dialysis and an increase in baseline serum creatinine levels as the most important predictors of in-hospital and long-term mortality. Thus, acute renal failure that requires dialysis after percutaneous coronary interventions is associated with very high in-hospital and 1-year mortality rates and a dramatic increase in hospital resource utilization.

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / therapy*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon* / adverse effects*
  • Angioplasty, Balloon* / mortality
  • Creatine Kinase / blood
  • Creatine Kinase, MB Form
  • Creatinine / blood
  • Female
  • Follow-Up Studies
  • Health Resources
  • Hospital Mortality
  • Humans
  • Incidence
  • Isoenzymes / blood
  • Kidney / metabolism
  • Logistic Models
  • Male
  • Metabolic Clearance Rate / physiology
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / etiology
  • Renal Dialysis
  • Sex Factors
  • Survival Analysis
  • Time
  • Treatment Outcome


  • Isoenzymes
  • Creatinine
  • Creatine Kinase
  • Creatine Kinase, MB Form