Background. Contrast-associated acute kidney injury (CA-AKI) is a major adverse effect of coronary angiography (CAG). Patients with chronic kidney disease (CKD) and coronary artery disease (CAD) are at high risk of CA-AKI. This study aimed to investigate the association between prognostic nutritional index (PNI) and CA-AKI in this high-risk population. Methods. This study enrolled a total of 4,391 patients. CA-AKI was defined as a serum creatinine increase ≥0.3 mg/dL or 50% from baseline within the first 48 hours following CAG. The PNI was calculated upon hospital admission: serum albumin (g/L) + 5 × total lymphocyte count (10⁹/L). PNI was analysed from the high level to low level as a continuous variable and categorical variable which was divided into four groups by quartile. Restricted cubic splines and logistic regression were applied. Results. Overall, 13.09% (575/4391) of patients developed CA-AKI. PNI score was significantly lower in patients with CA-AKI than that in patients without CA-AKI (). The relationship between PNI score and CA-AKI was linear. A logistic regression model revealed that decreased PNI score was associated with increased risk of CA-AKI [per 1-point decrement; adjusted OR = 1.08, 95% CI, 1.05–1.09; compared with Quartile 1 (PNI ≥ 46.30), Quartile 4 (PNI < 37.90), adjusted OR = 1.88, 95% CI: 1.41–2.51; and Quartile 3 (37.90 ≤ PNI < 42.15), adjusted OR = 1.37, 95% CI: 1.02–1.84]. Conclusion. Our study indicated a negative linear relationship between PNI score and CA-AKI in patients undergoing CAG complicated with CKD and CAD. It suggested that malnutrition is associated with increased risk of CA-AKI in this population.

中文翻译：

---

慢性肾脏病和冠状动脉疾病患者预后营养指数与造影剂相关急性肾损伤的相关性

背景。造影剂相关的急性肾损伤 (CA-AKI) 是冠状动脉造影 (CAG) 的主要不良反应。患有慢性肾病 (CKD) 和冠状动脉疾病 (CAD) 的患者发生 CA-AKI 的风险很高。本研究旨在调查这一高危人群的预后营养​​指数 (PNI) 与 CA-AKI 之间的关联。方法。这项研究共招募了 4,391 名患者。CA-AKI 定义为 CAG 后最初 48 小时内血清肌酐从基线增加≥0.3 mg/dL 或 50%。入院时计算 PNI：血清白蛋白 (g/L) + 5 × 总淋巴细胞计数 (10 ⁹/L)。PNI作为连续变量和分类变量从高水平到低水平进行分析，按四分位数分为四组。应用了受限三次样条和逻辑回归。结果。总体而言，13.09% (575/4391) 的患者发生 CA-AKI。CA-AKI 患者的 PNI 评分显着低于无 CA-AKI 患者。）。PNI 评分与 CA-AKI 呈线性关系。逻辑回归模型显示，PNI 评分降低与 CA-AKI 风险增加相关[每降低 1 分；调整后的 OR = 1.08, 95% CI, 1.05–1.09；与四分位数 1 (PNI ≥ 46.30)、四分位数 4 (PNI < 37.90) 相比，调整后的 OR = 1.88，95% CI：1.41–2.51；和四分位数 3 (37.90 ≤ PNI < 42.15)，调整后的 OR = 1.37，95% CI：1.02–1.84]。结论。我们的研究表明，在接受 CAG 并发 CKD 和 CAD 的患者中，PNI 评分与 CA-AKI 呈负线性关系。这表明营养不良与该人群中 CA-AKI 风险增加有关。