Preoperative systemic immune-inflammation index as a predictor of contrast-induced acute kidney injury in coronary artery disease: a multicenter cohort study.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Renal Failure Pub Date : 2025-12-01 Epub Date: 2025-03-24 DOI:10.1080/0886022X.2025.2474204
Jinlong Zhu, Pei Yu, Xiaoying Zhang, Xiaoming Li, Jiaming Huang, Shumin Zhao, Qingyan Ruan, Yibo He, Yang Zhou, Kunming Bao, Jiaming Xiu, Lin Deng, Yunchen Liu, Yong Liu, Shiqun Chen, Kaihong Chen, Liling Chen
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引用次数: 0

Abstract

Background: Inflammation is a key contributor to contrast-induced acute kidney injury (CI-AKI), yet its predictive role remains unclear. The systemic immune-inflammation index (SII) is a novel inflammatory biomarker, but its association with CI-AKI risk in coronary artery disease (CAD) patients undergoing coronary angiography is not well established. This study aimed to evaluate the relationship between preoperative SII and CI-AKI in a large multicenter cohort.

Methods: This retrospective cohort study analyzed CAD patients from five tertiary hospitals in China (2007-2020). Patients were stratified into SII tertiles, and multivariable logistic regression, restricted cubic splines (RCS), and two-piecewise logistic regression models were employed to assess the association between SII and CI-AKI risk.

Results: Among 30,822 patients, 3,246 (10.5%) developed CI-AKI. Higher preoperative SII levels were associated with increased CI-AKI risk ([SII-M vs. SII-L]: OR = 1.22, 95% CI [1.09-1.36], p = 0.001; [SII-H vs. SII-L]: OR = 1.70, 95% CI [1.53-1.90], p < 0.001). RCS analysis demonstrated a nonlinear relationship (p for nonlinearity = 0.008). The inflection point was at 19.12 × 1011/L. Below this inflection point, each 100-unit increase in SII correlated with a 5% higher CI-AKI risk (OR = 1.05, 95% CI [1.04-1.06], p < 0.001), while no significant association was observed above this level.

Conclusion: Preoperative SII may be an independent predictor of CI-AKI risk in CAD patients undergoing undergoing coronary angiography, demonstrating a nonlinear dose-response relationship with a significant threshold effect. These findings suggest that SII may serve as a useful biomarker for early CI-AKI risk stratification in clinical practice.

术前全身免疫炎症指数作为冠状动脉疾病造影剂引起的急性肾损伤的预测因子:一项多中心队列研究
背景:炎症是造影剂诱发急性肾损伤(CI-AKI)的一个关键因素,但其预测作用仍不明确。全身免疫炎症指数(SII)是一种新型炎症生物标志物,但它与接受冠状动脉造影术的冠状动脉疾病(CAD)患者的 CI-AKI 风险之间的关系尚未明确。本研究旨在评估大型多中心队列中术前 SII 与 CI-AKI 之间的关系:这项回顾性队列研究分析了中国五家三级医院的 CAD 患者(2007-2020 年)。结果:在30822例患者中,有3例患者在术后发生CI-AKI:结果:在 30,822 名患者中,有 3,246 人(10.5%)发生了 CI-AKI。术前 SII 水平越高,CI-AKI 风险越高([SII-M vs. SII-L]:OR = 1.22,95% CI [1.09-1.36],p = 0.001;[SII-H vs. SII-L]:OR = 1.70,95% CI [1.53-1.90],p 11/L。在此拐点以下,SII 每增加 100 单位,CI-AKI 风险就会增加 5%(OR = 1.05,95% CI [1.04-1.06],P 结论:术前 SII 可能是影响术后 CI-AKI 风险的重要因素:在接受冠状动脉造影术的 CAD 患者中,术前 SII 可能是 CI-AKI 风险的独立预测因子,表现出非线性剂量-反应关系,具有显著的阈值效应。这些研究结果表明,在临床实践中,SII 可作为早期 CI-AKI 风险分层的有用生物标志物。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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