Abstract 272: Association of Renal Insufficiency With Outcomes of Percutaneous Coronary Intervention

Background: Limited data are available on the impact of chronic kidney disease (CKD) and end stage renal disease (ESRD) on outcomes after percutaneous coronary intervention (PCI).Objectives: To determine the association between baseline renal insufficiency with in-hospital outcomes after PCI.Methods: We queried the 2003-2011 Nationwide Inpatient Sample databases to identify all patients aged ≥ 18 years undergoing PCI. Patients who underwent coronary artery bypass grafting during the same admission were excluded. Patients with concomitant diagnosis of CKD (ICD-9 codes 585.1-585.5 and 585.9) and ESRD (ICD-9 diagnosis code 585.6 or procedure code for hemodialysis [39.95, excluding patients with concurrent diagnosis of acute renal failure] or peritoneal dialysis [54.98]) were then identified. Multivariable logistic regression was used to compare outcomes between patients with CKD and patients with ESRD to those without CKD or ESRD.Results: Of 6,417,970 patients who underwent PCI, 93.3% (mean age 64.2±12.3 years, 33.7% females) had no CKD/ESRD; 4.9% (mean age 71.5±11.3 years, 35% females) had CKD; and 1.8% (mean age 64.2±11.8 years, 42.2% females) had The prevalence of smoking was highest in patients with no CKD/ESRD; that of dyslipidemia, coronary artery disease, prior myocardial infarction, atrial fibrillation, and obesity was highest in CKD patients; diabetes mellitus, hypertension, and congestive heart failure were most prevalent in ESRD patients (pu003c0.001 for all). Of patients undergoing PCI, 61.2% patients in no CKD/ESRD group had an acute coronary syndrome, as compared to 65.4% in CKD group, and 58.2% in ESRD group (pu003c0.001). Compared to patients with no CKD/ESRD, those with CKD and those with ESRD had higher in-hospital mortality and higher incidence of post-procedure hemorrhage. Baseline renal insufficiency was also associated with longer average length of stay and higher average total hospital charges (Table).Conclusions: In patients undergoing PCI, baseline renal insufficiency is associated with worse outcomes. Patients with CKD and patients with ESRD had increased in-hospital mortality, higher hemorrhagic complications, longer average length of hospital stay, and higher average hospital charges than those without CKD or ESRD. ![][1] [1]: /embed/graphic-1.gif