Ulyanovsk Medico-biological Journal

INTERNAL MEDICINE

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PROBLEMS OF DIAGNOSTICS ACUTE KIDNEY INJURY IN PATIENTS WITH ST-SEGMENT ELEVATION ACUTE MYOCARDIAL INFARCTION

M.V. Menzorov, A.M. Shutov, E.R. Makeeva, Yu.V. Saenko, I.Yu. Grishenkin

Ulyanovsk State University

 

The purpose of this study was to examine the incidence of the acute kidney injury (AKI), defined by the KDIGO Clinical Practice Guideline in patients with ST-segment elevation acute myocardial infarction, undergoing pharmacological reperfusion. According to KDIGO criteria, 64 (26 %) patients had AKI detected by basal serum creatinine, 59 (24 %) by serum creatinine shift from 1 to 3 hospital days and 84 (34 %) by urine output. AKI defined by urine output criteria was associated with inhospital mortality. In patients with AKI detected by basal serum creatinine, is unclear which is the cause of renal dysfunction: AKI or chronic kidney disease. The authors propose the term "first diagnosed kidney injury" to describe patients with impaired renal function observed for the first time.

Keywords: ST-segment elevation acute myocardial infarction, KDIGO Clinical Practice Guideline, acute kidney injury, chronic kidney disease, first diagnosed kidney injury.

 

References

  1. Влияние хронической болезни почек на прогноз больных хронической сердечной недостаточностью / А. М. Шутов [и др.] // Сердечная недостаточность. 2009. № 4. С. 22–24.

  2. Острое повреждение почек у больных инфарктом миокарда с подъемом сегмента ST / М. В. Мензоров [и др.] // Нефрология. 2012. № 1. С. 40–44.

  3. Фармакоэкономический анализ реальной стоимости стационарного лечения больного острым инфарктом миокарда с подъемом сегмента ST / П. В. Долотовская [и др.] // Сердце: журн. для практикующих врачей. 2012. № 3. С. 141–145.

  4. ACC/AHA/ESC Guidelines for the Manage-ment of Patients With Atrial Fibrillation A Report of the American College of Cardiology, American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Com-mittee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) // J. of the American College of Cardiology. 2001. Vol. 38. P. 1231–1266.

  5. Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission / G. Marenzi [et al.] // Crit Care Med. 2010. Vol. 38. P. 438–444.

  6. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury / R. L. Mehta [et al.] // Crit Care. 2007. Vol. 11. P. 31.

  7. Acute renal failure-definition, outcome measures, animal models, fluid therapy and infor-mation technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group / R. Bellomo [et al.] // Crit Care. 2004. Vol. 8. P. 204–212.

  8. Cardiorenal syndrome / C. Ronco [et al.]// J. Am. Coll. Cardiol. 2008. Vol. 52. P. 1527–1539.

  9. Chenoweth C. E., Saint S. Urinary tract infections // Infectious Disease Clinics of North America. 2011. Vol. 25. P. 103–115.

  10. Defining urine output criterion for acute kidney injury in critically ill patients / E. Macedo [et al.] // Nephrol. Dial Transplant. 2011. Vol. 26. P. 509–515.

  11. Does furosemide prevent renal dysfunction in high-risk cardiac surgical patients? Results of a double-blinded prospective randomised trial / B. Ma-hesh [et al.] // Eur. J. Cardiothorac Surg. 2008. Vol. 33. P. 370–376.

  12. Guidelines for the management of atrial fi brillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC) / A. J. Сamm [et al.] // Eur Heart J. 2010. Vol. 31. P. 2369–2429.

  13. In-hospital and 1-year mortality of patients who develop worsening renal function following acute ST-elevation myocardial infarction / A. Gold-berg [et al.] // Am Heart J. 2005. Vol. 150. P. 330–337.

  14. KDIGO Clinical Practice Guidelines for Acute Kidney Injury // Kidney International Supplements. 2012. Vol. 2. P. 5–138.

  15. Long-term Prognosis of Acute Kidney Injury After Acute Myocardial Infarction / C. R. Par-ikh [et al.] // Arch. Intern. Med. 2008. Vol. 168. P. 987–995.

  16. Markers of renal function and acute kidney injury in acute heart failure: definitions and impact on outcomes of the cardiorenal syndrome / J. P. E. Las-sus [et al.] // European Heart J. 2010. Vol. 31. P. 2791–2798.

  17. Nash K., Hafeez A., Hou S. Hospital-acquired renal insufficiency // Am. J. Kidney Dis. 2002. Vol. 39. P. 930–936.

  18. Neutrophil Gelatinase-Associated Lipoca-lin as a Predictor of Complications and Mortality in Patients Undergoing Non-Cardiac Major Surgery / L. Shavit [et al.] // Kidney Blood Press Res. 2011. Vol. 34. P. 116–124.

  19. Risk factors for acute renal failure: inherent and modifiable risks / M. Leblanc [et al.] // Curr Opin Crit Care. 2005. Vol. 11. P. 533–536.

  20. Rudnick M. R., Goldfarb S., Tumlin J. Contrast-induced nephropathy: is the picture any clearer? // Clin. J. Am. Soc. Nephrol. 2008. Vol. 3. P. 261–262.

  21. Urinary and serum biomarkers for the diagnosis of acute kidney injury: an in-depth review of the literature / J. Vanmassenhove [et al.] // Nephrol. Dial. Transplant. 2013. Vol. 28. P. 254–273.

  22. Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury / J. L. Koy-ner [et al.] // Clin. J. Am. Soc. Nephrol. 2010. Vol. 5. P. 2154–2165.

 

 

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УДК 616.61-008.64

ПРОБЛЕМЫ ДИАГНОСТИКИ ОСТРОГО ПОВРЕЖДЕНИЯ ПОЧЕК У БОЛЬНЫХ ИНФАРКТОМ МИОКАРДА С ПОДЪЕМОМ CЕГМЕНТА ST

М.В. Мензоров, А.М. Шутов, Е.Р. Макеева, Ю.В. Саенко, И.Ю. Гришенькин

Ульяновский государственный университет

 

В работе произведена оценка частоты и тяжести острого повреждения почек (ОПП) согласно Рекомендациям KDIGO у больных острым инфарктом миокарда с подъемом сегмента ST (ОИМпST), которым с целью коронарной реперфузии выполнялась тромболитическая терапия. Обнаружено, что при примерно равной частоте выявления ОПП по креатинину и диурезу диагностика по диурезу обладает большей прогностической значимостью в отношении внутригоспитальной летальности. Наибольшую сложность в диагностике ОПП вызывает разграничение больных с ОПП и хронической болезнью почек (ХБП), в связи с этим необходим дальнейший поиск биохимических маркеров острого повреждения почек, которые бы позволили решить эту задачу. Авторами предложен термин «впервые выявленное повреждение почек» для обозначения больных, у которых нарушение функции почек обнаружено de novo.

Ключевые слова: острый инфаркт миокарда с подъемом сегмента ST, Рекомендации KDIGO, острое повреждение почек, хроническая болезнь почек, впервые выявленное повреждение почек.

 

Литература

  1. Влияние хронической болезни почек на прогноз больных хронической сердечной недостаточностью / А. М. Шутов [и др.] // Сердечная недостаточность. 2009. № 4. С. 22–24.

  2. Острое повреждение почек у больных инфарктом миокарда с подъемом сегмента ST / М. В. Мензоров [и др.] // Нефрология. 2012. № 1. С. 40–44.

  3. Фармакоэкономический анализ реальной стоимости стационарного лечения больного острым инфарктом миокарда с подъемом сегмента ST / П. В. Долотовская [и др.] // Сердце: журн. для практикующих врачей. 2012. № 3. С. 141–145.

  4. ACC/AHA/ESC Guidelines for the Manage-ment of Patients With Atrial Fibrillation A Report of the American College of Cardiology, American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Com-mittee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) // J. of the American College of Cardiology. 2001. Vol. 38. P. 1231–1266.

  5. Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission / G. Marenzi [et al.] // Crit Care Med. 2010. Vol. 38. P. 438–444.

  6. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury / R. L. Mehta [et al.] // Crit Care. 2007. Vol. 11. P. 31.

  7. Acute renal failure-definition, outcome measures, animal models, fluid therapy and infor-mation technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group / R. Bellomo [et al.] // Crit Care. 2004. Vol. 8. P. 204–212.

  8. Cardiorenal syndrome / C. Ronco [et al.]// J. Am. Coll. Cardiol. 2008. Vol. 52. P. 1527–1539.

  9. Chenoweth C. E., Saint S. Urinary tract infections // Infectious Disease Clinics of North America. 2011. Vol. 25. P. 103–115.

  10. Defining urine output criterion for acute kidney injury in critically ill patients / E. Macedo [et al.] // Nephrol. Dial Transplant. 2011. Vol. 26. P. 509–515.

  11. Does furosemide prevent renal dysfunction in high-risk cardiac surgical patients? Results of a double-blinded prospective randomised trial / B. Ma-hesh [et al.] // Eur. J. Cardiothorac Surg. 2008. Vol. 33. P. 370–376.

  12. Guidelines for the management of atrial fi brillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC) / A. J. Сamm [et al.] // Eur Heart J. 2010. Vol. 31. P. 2369–2429.

  13. In-hospital and 1-year mortality of patients who develop worsening renal function following acute ST-elevation myocardial infarction / A. Gold-berg [et al.] // Am Heart J. 2005. Vol. 150. P. 330–337.

  14. KDIGO Clinical Practice Guidelines for Acute Kidney Injury // Kidney International Supplements. 2012. Vol. 2. P. 5–138.

  15. Long-term Prognosis of Acute Kidney Injury After Acute Myocardial Infarction / C. R. Par-ikh [et al.] // Arch. Intern. Med. 2008. Vol. 168. P. 987–995.

  16. Markers of renal function and acute kidney injury in acute heart failure: definitions and impact on outcomes of the cardiorenal syndrome / J. P. E. Las-sus [et al.] // European Heart J. 2010. Vol. 31. P. 2791–2798.

  17. Nash K., Hafeez A., Hou S. Hospital-acquired renal insufficiency // Am. J. Kidney Dis. 2002. Vol. 39. P. 930–936.

  18. Neutrophil Gelatinase-Associated Lipoca-lin as a Predictor of Complications and Mortality in Patients Undergoing Non-Cardiac Major Surgery / L. Shavit [et al.] // Kidney Blood Press Res. 2011. Vol. 34. P. 116–124.

  19. Risk factors for acute renal failure: inherent and modifiable risks / M. Leblanc [et al.] // Curr Opin Crit Care. 2005. Vol. 11. P. 533–536.

  20. Rudnick M. R., Goldfarb S., Tumlin J. Contrast-induced nephropathy: is the picture any clearer? // Clin. J. Am. Soc. Nephrol. 2008. Vol. 3. P. 261–262.

  21. Urinary and serum biomarkers for the diagnosis of acute kidney injury: an in-depth review of the literature / J. Vanmassenhove [et al.] // Nephrol. Dial. Transplant. 2013. Vol. 28. P. 254–273.

  22. Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury / J. L. Koy-ner [et al.] // Clin. J. Am. Soc. Nephrol. 2010. Vol. 5. P. 2154–2165.