Trends in incidence and mortality of acute kidney disease following coronary angiography in Chinese population: 2008–2017

Background

Acute kidney disease (AKD) has received increasing attention owing to its poor prognosis. However, few studies have investigated the trends in AKD incidence and prognosis among patients undergoing coronary angiography (CAG). Therefore, this study was designed to explore trends in the incidence and mortality of AKD following CAG in China.

Methods

We enrolled patients undergoing CAG using data of the Cardiorenal Improvement (CIN) cohort registry of Guangdong Provincial People's Hospital. Univariate and multivariate logistic regression analyses were applied to examine the incidence of AKD from 2008 to 2017. Mortality rates are presented as deaths per 1000 person-years and were evaluated in univariate and multivariate Cox regression analyses.

Results

A total of 9665 patients (mean age: 61.6 ± 9.6 years, 40% women) were enrolled in the final analysis. From 2008 to 2017, the overall incidence and mortality of AKD were 19% and 323.0 per 1000 person-years, respectively. The incidence of AKD decreased from 25% to 13% during 2008–2017 (adjusted odds ratio, 0.40; 95% confidence interval [CI], 0.31–0.51; p < 0.01; p for trend <0.01). However, the mortality of AKD increased significantly from 138.2 to 544.1 per 1000 person-years (adjusted hazard ratio, 2.85; 95% CI, 1.20–6.73; p = 0.02, p for trend = 0.02). The above trends were observed consistently in patients stratified by sex and age.

Conclusions

Our findings suggest a significant decrease in incidence and an increase in mortality of AKD following CAG from 2008 to 2017 in China. We advocate for more proactive measures to prevent AKD and improve the prognosis of patients with AKD.