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Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention.

Publication ,  Journal Article
Lunyera, J; Clare, RM; Chiswell, K; Scialla, JJ; Pun, PH; Thomas, KL; Starks, MA; Diamantidis, CJ
Published in: J Am Soc Nephrol
March 2021

BACKGROUND: Undergoing percutaneous coronary intervention (PCI) is a risk factor for AKI development, but few studies have quantified racial differences in AKI incidence after this procedure. METHODS: We examined the association of self-reported race (Black, White, or other) and baseline eGFR with AKI incidence among patients who underwent PCI at Duke University Medical Center between January 1, 2003, and December 31, 2013. We defined AKI as a 0.3 mg/dl absolute increase in serum creatinine within 48 hours, or ≥1.5-fold relative elevation within 7 days post-PCI from the reference value ascertained within 30 days before PCI. RESULTS: Of 9422 patients in the analytic cohort (median age 63 years; 33% female; 75% White, 20% Black, 5% other race), 9% developed AKI overall (14% of Black, 8% of White, 10% of others). After adjustment for demographics, socioeconomic status, comorbidities, predisposing medications, PCI indication, periprocedural AKI prophylaxis, and PCI procedural characteristics, Black race was associated with increased odds for incident AKI compared with White race (odds ratio [OR], 1.79; 95% confidence interval [95% CI], 1.48 to 2.15). Compared with Whites, odds for incident AKI were not significantly higher in other patients (OR, 1.30; 95% CI, 0.93 to 1.83). Low baseline eGFR was associated with graded, higher odds of AKI incidence (P value for trend <0.001); however, there was no interaction between race and baseline eGFR on odds for incident AKI (P value for interaction = 0.75). CONCLUSIONS: Black patients had greater odds of developing AKI after PCI compared with White patients. Future investigations should identify factors, including multiple domains of social determinants, that predispose Black individuals to disparate AKI risk after PCI.

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Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

March 2021

Volume

32

Issue

3

Start / End Page

654 / 662

Location

United States

Related Subject Headings

  • White People
  • Urology & Nephrology
  • Risk Factors
  • Race Factors
  • Preoperative Period
  • Percutaneous Coronary Intervention
  • Odds Ratio
  • North Carolina
  • Middle Aged
  • Male
 

Citation

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Lunyera, J., Clare, R. M., Chiswell, K., Scialla, J. J., Pun, P. H., Thomas, K. L., … Diamantidis, C. J. (2021). Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention. J Am Soc Nephrol, 32(3), 654–662. https://doi.org/10.1681/ASN.2020040502
Lunyera, Joseph, Robert M. Clare, Karen Chiswell, Julia J. Scialla, Patrick H. Pun, Kevin L. Thomas, Monique A. Starks, and Clarissa J. Diamantidis. “Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention.J Am Soc Nephrol 32, no. 3 (March 2021): 654–62. https://doi.org/10.1681/ASN.2020040502.
Lunyera J, Clare RM, Chiswell K, Scialla JJ, Pun PH, Thomas KL, et al. Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention. J Am Soc Nephrol. 2021 Mar;32(3):654–62.
Lunyera, Joseph, et al. “Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention.J Am Soc Nephrol, vol. 32, no. 3, Mar. 2021, pp. 654–62. Pubmed, doi:10.1681/ASN.2020040502.
Lunyera J, Clare RM, Chiswell K, Scialla JJ, Pun PH, Thomas KL, Starks MA, Diamantidis CJ. Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention. J Am Soc Nephrol. 2021 Mar;32(3):654–662.

Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

March 2021

Volume

32

Issue

3

Start / End Page

654 / 662

Location

United States

Related Subject Headings

  • White People
  • Urology & Nephrology
  • Risk Factors
  • Race Factors
  • Preoperative Period
  • Percutaneous Coronary Intervention
  • Odds Ratio
  • North Carolina
  • Middle Aged
  • Male