Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention

Circulation. 2002 May 14;105(19):2259-64. doi: 10.1161/01.cir.0000016043.87291.33.


Background: In patients undergoing percutaneous coronary intervention (PCI) in the modern era, the incidence and prognostic implications of acute renal failure (ARF) are unknown.

Methods and results: With a retrospective analysis of the Mayo Clinic PCI registry, we determined the incidence of, risk factors for, and prognostic implications of ARF (defined as an increase in serum creatinine [Cr] >0.5 mg/dL from baseline) after PCI. Of 7586 patients, 254 (3.3%) experienced ARF. Among patients with baseline Cr <2.0, the risk of ARF was higher among diabetic than nondiabetic patients, whereas among those with a baseline Cr >2.0, all had a significant risk of ARF. In multivariate analysis, ARF was associated with baseline serum Cr, acute myocardial infarction, shock, and volume of contrast medium administered. Twenty-two percent of patients with ARF died during the index hospitalization compared with only 1.4% of patients without ARF (P<0.0001). After adjustment, ARF remained strongly associated with death. Among hospital survivors with ARF, 1- and 5-year estimated mortality rates were 12.1% and 44.6%, respectively, much greater than the 3.7% and 14.5% mortality rates in patients without ARF (P<0.0001).

Conclusions: The overall incidence of ARF after PCI is low. Diabetic patients with baseline Cr values <2.0 mg/dL are at higher risk than nondiabetic patients, whereas all patients with a serum Cr >2.0 are at high risk for ARF. ARF was highly correlated with death during the index hospitalization and after dismissal.

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / etiology*
  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Comorbidity
  • Creatine / blood
  • Diabetes Mellitus / epidemiology
  • Female
  • Hospital Mortality
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Multivariate Analysis
  • Myocardial Infarction / blood
  • Myocardial Infarction / surgery
  • Odds Ratio
  • Postoperative Complications / epidemiology
  • Prognosis
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Analysis


  • Creatine