RESULTS
In this study, among 1826536 patients who were candidates for PCI from 2005 to 2011, 113018 patients (6.2%) suffered from ACKD, based on the criteria for diagnosis of chronic kidney disease. Patients with kidney disease mostly were older and had histories of diabetics, peripheral artery disease, cerebrovascular accidents, and atrial fibrillation as compared to the patients without renal insufficiency (Table 1). The evaluation of the trend of the changes in procedural mortality during the evaluated years (from 2005 to 2011) in two groups of patients with and without advanced chronic kidney disease indicated higher age-adjusted inpatient mortality rate in the group with ACKD in each year studied compared to those without this co-morbidity. However, over the years mortality in ACKD patients undergoing PCI improved over the years study while it was stable with a mild increase in non-CKD patients. (Figure 1)    For the first year studied in 2006, age age-adjusted mortality rate for patients undergoing PCI was 149 per 100,000 vs 48 per 100,000 in patients without ACKD (p<0001). For the last year studied in 2011, age-adjusted mortality was 124.1 per 100,000 in ACKD patients vs 40.4 per 100,000 in patients with no ACKD, (P <0.0001).
Using the multivariable logistic regression modeling adjusting for baseline parameters and cardiovascular risk factors such as diabetes mellitus, hypertension, hyperlipidemia, peripheral artery disease,  atrial fibrillation, cerebrovascular disease, myocardial infarction, and tobacco use, ACKD remained independently associated with higher mortality (OR 1.32,  CI 1.27-1.36, P<0.001) (OR = 1.32, P < 0.001) following PCI. Furthermore, an increasing trend of PCI performed in ACKD patients was noted over the years studied (Figure 2).