The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injury

Background: The most serious side effect of percutaneous coronary intervention (PCI) is contrast-associated acute kidney damage (CA-AKI), an injury to the kidneys caused by the body's reaction to the contrast chemicals that were injected into the bloodstream. Objectives: The purpose of this tr...

Full description

Bibliographic Details
Main Authors: Noher M. Abass*, Mohamed H. El-Rashidy
Format: Article
Language:English
Published: South Valley University, Faculty of Medicine 2023-07-01
Series:SVU - International Journal of Medical Sciences
Subjects:
Online Access:https://svuijm.journals.ekb.eg/article_327393.html
_version_ 1797388596924121088
author Noher M. Abass*
Mohamed H. El-Rashidy
author_facet Noher M. Abass*
Mohamed H. El-Rashidy
author_sort Noher M. Abass*
collection DOAJ
description Background: The most serious side effect of percutaneous coronary intervention (PCI) is contrast-associated acute kidney damage (CA-AKI), an injury to the kidneys caused by the body's reaction to the contrast chemicals that were injected into the bloodstream. Objectives: The purpose of this trial was to assess the correlation among the De-Ritis ratio & CA-AKI in PCI. Patients and methods: Five hundred people with ischemic heart disease (IHD) who had PCI were included in this study. Complete medical histories and physical examinations were performed on all individuals. Upon admittance, or the following morning, blood routine testing, aspartate aminotransferase, fasting lipid profile, samples from blood were taken for alanine aminotransferase, international normalized ratio, bilirubin, fasting blood glucose, evaluation of Uric Acid in the Blood. The aspartate aminotransferase-to-alanine aminotransferase ratio was determined by aspartate aminotransferase (AST) activity (U/L)/ALT alanine aminotransferase (U/L). Results: A total number of 500 cases undergoing elective PCI was enrolled. Mean of Model for End Stage Lived Disease (MELD) score was 7.25 & ranged from 7 to 9 and Mean of Model for End Stage Lived Disease excluding INR (MELD-XI) score was 9.97 and ranged from 9 to 11. A total of 35 (7%) patients developed AKI. AST/ALT ratio can detect AKI at cutoff 1.1 with sensitivity, specificity was 100%, and 58.1% respectively (p< 0.001) and AUC was 0.761 as illustrated in table (3) and figure (1). ALT can detect AKI at cutoff 19 with sensitivity, specificity was 100%, and 81.7% respectively (p< 0.001) and AUC was 0.896. Model for End-Stage Liver Disease score can detect AKI at cutoff 7 with sensitivity, specificity was 42.9%, and 77.4% respectively (p< 0.001) and AUC was 0.608. MELD excluding international normalized ratio score can detect AKI at cutoff 9 with sensitivity, specificity was 42.9%, and 82.8% respectively (p< 0.001) and AUC (Area under the curve) was 0.677. ALT had the best AUC followed by aspartate aminotransferase to alanine aminotransferase ratio then Model for End-Stage Liver Disease -XI scores and MELD score. Conclusion: Long-term unfavorable clinical results are related with a high De Ritis ratio among individuals receiving elective PCI, as well a cut off value of over 1.1 makes the De Ritis ratio a good predictor for CA-AKI.
first_indexed 2024-03-08T22:43:03Z
format Article
id doaj.art-2d5f688d82b84420be0c3f92c31b4f6c
institution Directory Open Access Journal
issn 2735-427X
2636-3402
language English
last_indexed 2024-03-08T22:43:03Z
publishDate 2023-07-01
publisher South Valley University, Faculty of Medicine
record_format Article
series SVU - International Journal of Medical Sciences
spelling doaj.art-2d5f688d82b84420be0c3f92c31b4f6c2023-12-17T08:12:37ZengSouth Valley University, Faculty of MedicineSVU - International Journal of Medical Sciences2735-427X2636-34022023-07-0162 851862https://doi.org/10.21608/svuijm.2023.244348.1725The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injuryNoher M. Abass*0Mohamed H. El-Rashidy1 Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Sohag University, Sohag, EgyptDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Sohag University, Sohag, EgyptBackground: The most serious side effect of percutaneous coronary intervention (PCI) is contrast-associated acute kidney damage (CA-AKI), an injury to the kidneys caused by the body's reaction to the contrast chemicals that were injected into the bloodstream. Objectives: The purpose of this trial was to assess the correlation among the De-Ritis ratio & CA-AKI in PCI. Patients and methods: Five hundred people with ischemic heart disease (IHD) who had PCI were included in this study. Complete medical histories and physical examinations were performed on all individuals. Upon admittance, or the following morning, blood routine testing, aspartate aminotransferase, fasting lipid profile, samples from blood were taken for alanine aminotransferase, international normalized ratio, bilirubin, fasting blood glucose, evaluation of Uric Acid in the Blood. The aspartate aminotransferase-to-alanine aminotransferase ratio was determined by aspartate aminotransferase (AST) activity (U/L)/ALT alanine aminotransferase (U/L). Results: A total number of 500 cases undergoing elective PCI was enrolled. Mean of Model for End Stage Lived Disease (MELD) score was 7.25 & ranged from 7 to 9 and Mean of Model for End Stage Lived Disease excluding INR (MELD-XI) score was 9.97 and ranged from 9 to 11. A total of 35 (7%) patients developed AKI. AST/ALT ratio can detect AKI at cutoff 1.1 with sensitivity, specificity was 100%, and 58.1% respectively (p< 0.001) and AUC was 0.761 as illustrated in table (3) and figure (1). ALT can detect AKI at cutoff 19 with sensitivity, specificity was 100%, and 81.7% respectively (p< 0.001) and AUC was 0.896. Model for End-Stage Liver Disease score can detect AKI at cutoff 7 with sensitivity, specificity was 42.9%, and 77.4% respectively (p< 0.001) and AUC was 0.608. MELD excluding international normalized ratio score can detect AKI at cutoff 9 with sensitivity, specificity was 42.9%, and 82.8% respectively (p< 0.001) and AUC (Area under the curve) was 0.677. ALT had the best AUC followed by aspartate aminotransferase to alanine aminotransferase ratio then Model for End-Stage Liver Disease -XI scores and MELD score. Conclusion: Long-term unfavorable clinical results are related with a high De Ritis ratio among individuals receiving elective PCI, as well a cut off value of over 1.1 makes the De Ritis ratio a good predictor for CA-AKI.https://svuijm.journals.ekb.eg/article_327393.htmlaspartate aminotransferase percutaneous coronary intervention de ritis ratio alanine aminotransferase aki
spellingShingle Noher M. Abass*
Mohamed H. El-Rashidy
The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injury
SVU - International Journal of Medical Sciences
aspartate aminotransferase percutaneous coronary intervention de ritis ratio alanine aminotransferase aki
title The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injury
title_full The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injury
title_fullStr The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injury
title_full_unstemmed The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injury
title_short The value of De Ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast-associated acute kidney injury
title_sort value of de ritis ratio in patients undergoing percutaneous coronary intervention for prediction of contrast associated acute kidney injury
topic aspartate aminotransferase percutaneous coronary intervention de ritis ratio alanine aminotransferase aki
url https://svuijm.journals.ekb.eg/article_327393.html
work_keys_str_mv AT nohermabass thevalueofderitisratioinpatientsundergoingpercutaneouscoronaryinterventionforpredictionofcontrastassociatedacutekidneyinjury
AT mohamedhelrashidy thevalueofderitisratioinpatientsundergoingpercutaneouscoronaryinterventionforpredictionofcontrastassociatedacutekidneyinjury
AT nohermabass valueofderitisratioinpatientsundergoingpercutaneouscoronaryinterventionforpredictionofcontrastassociatedacutekidneyinjury
AT mohamedhelrashidy valueofderitisratioinpatientsundergoingpercutaneouscoronaryinterventionforpredictionofcontrastassociatedacutekidneyinjury