Admission proteinuria predicts the incidence of acute kidney injury among patients with acute ST-segment elevation myocardial infarction: a retrospective cohort study

Coron Artery Dis. 2024 May 1;35(3):215-220. doi: 10.1097/MCA.0000000000001345. Epub 2024 Mar 4.

Abstract

Background: Proteinuria indicates renal dysfunction and is associated with the development of acute kidney injury (AKI) in several conditions, but the association between proteinuria and AKI in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. This research aims to investigate the predictive value of proteinuria for the development of AKI in STEMI patients.

Methods: A total of 2735 STEMI patients were enrolled. The present study's endpoint was AKI incidence during hospitalization. AKI is defined according to the Kidney Disease: Improving Global Outcomes criteria. We defined proteinuria, measured with a dipstick, as mild (1+) or heavy (2+ to 4+). Multivariate logistic regression and subgroup analyses were used to testify to the association between proteinuria and AKI.

Results: Overall, proteinuria was observed in 634 (23.2%) patients. Multivariate logistic regression analyses revealed that proteinuria [odds ratio (OR), 1.58; 95% confidence interval (CI), 1.25-2.00; P < 0.001] was the independent predictive factor for AKI. Severe proteinuria was associated with a higher adjusted risk for AKI compared with the nonproteinuria group (mild proteinuria: OR, 1.35; 95% CI, 1.04-1.75; P = 0.025; severe proteinuria: OR, 2.50; 95% CI, 1.70-3.68; P < 0.001). The association was highly consistent across all studied subgroups. (all P for interaction >0.05).

Conclusion: Admission proteinuria measured using a urine dipstick is an independent risk factor for the development of AKI in STEMI patients.

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / etiology
  • Anterior Wall Myocardial Infarction* / complications
  • Arrhythmias, Cardiac / complications
  • Hospitalization
  • Humans
  • Incidence
  • Percutaneous Coronary Intervention* / adverse effects
  • Proteinuria / complications
  • Proteinuria / diagnosis
  • Proteinuria / epidemiology
  • Retrospective Studies
  • Risk Factors
  • ST Elevation Myocardial Infarction* / diagnosis
  • ST Elevation Myocardial Infarction* / epidemiology
  • ST Elevation Myocardial Infarction* / therapy