Clinical Analysis Of Patients With Acute Kidney Injury After Acute Myocardial Infarction

Objective:To investigate the incidence of acute kidney injury(AKI)in patients after acute myocardial infarction(AMI),and to explore the risk factors of AKI in patients with AMI.Thereby identifying high-risk patients and guiding clinical work.Methods:According to the inclusion and exclusion criteria,a total of 204 patients with AMI admitted to the Department of Cardiology from the First Affiliated Hospital of Soochow University from January 2017 to December 2017 were enrolled.Based on the occurrence of AKI,the patients were divided into AKI group and non-AKI group.The clinical data(epidemiological data,laboratory and auxiliary examination,treatment and prognosis)were collected according to the study.Risk factors for AMI complicated with AKI were analyzed by univariate and multivariate logistic regression.Data were analyzed using SPSS 20.0 statistical software.Results:1.Among the 204 patients with AMI,89 patients developed AKI(AKI group),accounting for 43.6%.115 patients did not have AKI(non-AKI group),accounting for 56.4%.Among these patients,73 cases were in AKI stage 1,14 cases in AKI stage 2,2 cases of AKI stage 3.2.Compared with non-AKI group,factors such as age,diabetes,stroke,chronic kidney disease(CKD)and the incidence of arrhythmia in AKI group were significantly higher(P<0.05).There was no significant difference in gender ratio,history of smoking and drinking,hypertension,hyperlipidemia,coronary heart disease,heart rate,SBP,and DBP levels.3.Compared with non-AKI group,factors such as WBC,NE,RDW,urine protein,urinary red blood cells,FBG,BUN,Scr,UA,NT-BNP,hs-CRP in AKI group were significantly higher(P<0.05).While factors such as RBC,Hb,ALB,TG,apoA,PAB,eGFR,P in AKI group were less than the non-AKI group(P<0.05).LVEF was significantly lower in patients with AMI complicated with AKI,and LA was larger.While the PLVW,I VS and LVDd in both groups had no significant difference.4.Compared with non-AKI group,the AKI patients had significantly longer hospitalization,higher diuretic and antibiotic usage rate,lower rate of improvement,higher rate of automatic discharge and mortality(P<0.05).There were no significant differences in the usage rate of ACEI/ARB,antiplatelet drugs,lipid-regulated drugs,and renal replacement therapy.5.Two logistic regression models were established in this study.The results showed that diabetes history,high RDW,high NT-BNP,using antibiotic,and arrhythmia at admission were independent risk factors for AKI in patients after AMI,while high eGFR and high LVEF were protective factors.Conclusion:The incidence of AKI was significantly higher in patients with AMI,and was mainly in AKI 1 stage.AMI patients were at high risk of developing AKI.History of diabetes,high RDW,high NT-BNP,using antibiotic,arrhythmia at admission were the independent risk factors for AKI,while high eGFR and high LVEF were protective factors.This findings will help clinicians identify high-risk patients and take preventive measures earlier.