Serum albumin level as a predictor of contrast-induced acute kidney injury following coronary angiography

Abstract

Introduction: The association between serum albumin level and the risk of contrast-induced acute kidney injury (CI-AKI) after coronary angiography has not been well established. Material and methods: A retrospective chart review was performed for all patients who underwent coronary angiography with or without percutaneous coronary intervention (PCI) at a tertiary care medical center over a peri-od of 5 years. CI-AKI was defined as an absolute increase in creatinine of 0.3 mg/dl from baseline within 48 h of contrast exposure. Mean pre-procedural albumin level was compared between patients who developed CI-AKI and those who did not. The optimal cut-off point was obtained from the receiver operating characteristic (ROC) curve and univariate multiple logistic regression analysis was used to assess the associated risk of CI-AKI. Results: Among 1319 patients (females = 32.3%, mean age: 58.2 ± 13.6 years) included in the study, 201 (15.2%) developed CI-AKI. Baseline serum albumin (3.5 vs. 3.8 gm/dl, p < 0.001) was significantly lower in patients who developed CI-AKI. ROC curve analysis revealed an optimal cutoff value for serum albumin of 3.85 gm/dl to predict CI-AKI with 67.2% sensitivity and 52.2% specificity (area under the curve (AUC) = 0.62, p < 0.001). Serum albumin < 3.85 gm/dl is significantly associated with higher risk of developing CI-AKI (adjusted odds ratio (AOR) = 1.5, 95% CI: 1.1–2.1, p = 0.02). Conclusions: Serum albumin < 3.85 gm/dl is an independent predictor of CI-AKI in patients undergoing coronary angiography.