Acute kidney injury and multivessel percutaneous coronary interventions in chronic renal disease: The amicistudy

BACKGROUND: Patients with chronic kidney disease (CKD) often have multivessel coronary artery disease and the risk of acute kidney injury (AKI) after percutaneous coronary interventions (PCI) is high. The aim of this study was to evaluate the risk of AKIin patients with CKDwho underwent single vessel PCIversus multivessel PCI. METHODS: We retrospectively screened all PCIperformed from January 2011 to December 2017 and we included all the procedures performed in patients with a baseline glomerular filtration rate <60 mL/min/1.73 m2. PCIwere divided in two groups according to the treatment of a single vessel (mono group) or multivessel PCI(multi group). The multi group was also divided in two subgroups according to the modality of PCI: Multivessel PCIperformed in one procedure (multi-single session group) or in multiple staged procedures (multi-staged group). RESULTS: From a total of 4517 PCIscreened, 848 PCIwere included, 530 in the mono group and 318 in the multi group. The global rate of AKI was around 15% without significant differences between the mono and the multi group (15.5% in the mono and 14.8% in the multi group, P=0.786). In the multi group, the risk of AKI was significantly higher in the Single session sub-group (21.4%) compared to the staged sub-group (11.2%, P=0.014). CONCLUSIONS: In patients with CKD, the risk of AKIdid not differ in patients who underwent single vessel versus multivessel PCI, but multivessel PCIshould be performed in multiple staged procedures rather than in a single session.