The Risk Factors Of Contrast-induced Acute Kidney Injury In Patients Undergoing Percutaneous Coronary Intervention And The Influence Of Different Doses Of Atorvastatin Pretreatment

Objective To study the risk factors of contrast-induced acute kidney injury inpatients undergoing percutaneous coronary intervention and the short-term influenceof renal function and inflammatory response after different doses of atorvastatinpretreatment.Methods169patients who underwent elective PCI were randomly divided into20mg statin group (n=84) and40mg statin group (n=85). Each group of patientsrespectively received atorvastatin20mg and40mg per night3days before PCI. Werespectively measured every patient’s renal function and inflammation markers before,24hours and48hours after PCI. According to whether the occurrence ofcontrast-induced acute kidney injury (CIAKI), the patients were divided into CIAKIgroup and non CIAKI group, then we analyzed the risk factors of contrast-inducedacute kidney injury by using logistic regression and the short-term influence of renalfunction and inflammatory response after different doses of atorvastatin pretreatment.Results (1) The levels of BUN, Ccr, urine transfemin and Fib were no significantdifference between the two groups before,24hours and48hours after PCI (P＞0.05).24hours after PCI, Scr, urine α1-microglobulin and urine microamount albumin in40mg statin group were lower than20mg statin group (P＜0.05), and there was nosignificant difference in eGFR between the two groups (P＞0.05).48housr after PCI,Scr, urine microamount albumin in40mg statin group were lower than20mg statingroup (P＜0.05), eGFR in40mg statin group was higher than20mg statin group (P＜0.05), and there was no significant difference in urine α1-microglobulin between thetwo groups (P＞0.05).(2) Comparing with20mg statin group, hsCRP was lower in40mg statin group48hours after PCI (P＜0.05), and there was no significant difference24hours after PCI (P＞0.05).(3) The incidence of CIAKI in the20mg statin group was higher than40mg statin group (21.4%vs9.4%, P＜0.05).(4) Preoperative eGFR＜60ml/min, volume of contrast medium, the usage of diuretics and lower HCT (male＜0.39, female＜0.36) were independent risk factors for CIAKI.Conclusions (1) Preoperative renal dysfunction, volume of contrast medium, theusage of diuretics and lower HCT were independent risk factors for CIAKI.(2)Atorvastatin had a protective effect of short term renal function and inflammatoryresponse for the patients after PCI and reduced the incidence of CIAKI, and had adose-effect relationship.