Serum albumin level as a predictor of contrast-induced acute kidney injury following coronary angiography
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Department of Cardiology, Westchester Medical Center, Valhalla, USA
Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, USA
Department of Cardiology, Kansas University Medical Center, KC, USA
Department of Nephrology, Beth Israel Deaconess Medical Center, Boston, MA
Submission date: 2020-04-25
Final revision date: 2020-04-27
Acceptance date: 2020-04-27
Publication date: 2020-05-15
Arch Med Sci Civil Dis 2020;5(1):29-34
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 period 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.

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).

Serum albumin < 3.85 gm/dl is an independent predictor of CI-AKI in patients undergoing coronary angiography.

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