Acute Kidney Injury in Patients with Acute Myocardial Infarction. Modern Approach to Diagnostics

82 patients aged from 34 up to 89 years old with acute myocardial infarction were examined. Q-wave myocardial infarction was diagnosed in 56 (68%) patients, non-Q-wave myocardial infarction - in 26 (32%) patients. Myocardial systolic function, serum creatinine level, and glomerular filtration rate (CKD-EPI formula) were assessed. Prevalence of acute kidney injury according to KDIGO 2012 criteria was 85% (n = 70). Albuminuria, kidney injury molecule-1, and neutrophil gelatinase-associated lipocalin which characterized structural kidney injury were examined in 50 of 82 patients. Renal hemodynamics was assessed in 32 of 82 patients by Vivid e (GE HC, USA) ultrasound scanner equipped with a convex probe (2-5 MHz). Interlobar renal arteries resistive index was calculated. There was not any significant difference of myocardial infarction type (Q-wave and non-Q-wave) prevalence related to acute kidney injury. There was not any significant difference between left ventricular ejection fraction and frequency of systolic myocardial disfunction (left ventricular ejection fraction <40.0%) related to acute kidney injury as well. Interlobar renal arteries resistive index was significantly higher in patients with acute kidney injury comparing with patients without that (0.74 (0.71-0.76, 0.68-0.85) and 0.64 (0.64-0.66, 0.60-0.77), respectively) (median, 25-75th percentiles, minimal - maximal values) (P = 0.00082). Significant correlations were found out between interlobar renal arteries resistive index from one side and level of serum creatinine (r _S = 0.43, P < 0.05) and age (r _S = 0.35, P < 0.05) from other side. There was an inverse correlation between interlobar renal arteries resistive index and level of glomerular filtration rate (CKD-EPI formula) (r _S = -0.67, P < 0.05).

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