{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T21:32:11Z","timestamp":1753738331675,"version":"3.37.3"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023544","name":"National Taiwan University Hospital Hsin-Chu Branch","doi-asserted-by":"publisher","award":["112-HCH106, 113-HCH092"],"award-info":[{"award-number":["112-HCH106, 113-HCH092"]}],"id":[{"id":"10.13039\/501100023544","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007647","name":"College of Medicine, National Taiwan University","doi-asserted-by":"publisher","award":["113-GH041"],"award-info":[{"award-number":["113-GH041"]}],"id":[{"id":"10.13039\/501100007647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>We developed a comprehensive kidney protection strategy (KPS), which comprises left ventricular end-diastolic pressure-guided saline hydration, ultralow contrast coronary angiography, and a staged coronary revascularization procedure under suitable conditions. This study aimed to investigate KPS\u2019s effect on the risk of developing contrast-associated acute kidney injury (CA-AKI) among persons with moderate-to-advanced kidney insufficiency (KI). Seventy patients who had undergone cardiac catheterization with an estimated glomerular filtration rate (eGFR) of 15\u201345 mL\/min\/1.73 m<jats:sup>2<\/jats:sup> were investigated retrospectively. Among these, 19 patients who had received KPS and 51 who had undergone cardiac catheterization with usual care (UC) were enrolled. CA-AKI was defined as a 0.3-mg\/dL increase in serum creatinine levels or dialysis initiation within 72 h after contrast exposure. The inverse probability of treatment weighting (IPTW)-adjusted cohort was analyzed according to the Mehran 2 risk categories. Patients\u2019 mean age was 73.3 \u00b1 9.6 years; mean eGFR was 29.8 \u00b1 8.5 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>; and median of Mehran 2 risk score, 8. Most patients presented with acute myocardial infarction (AMI) or heart failure, and one-fifth of the administered cardiac catheterizations were emergency procedures. After the IPTW adjustment, the KPS group showed a significantly lower CA-AKI risk than the UC group (4% vs. 20.4%; odds ratio 0.19, 95% confidence interval 0.05\u20130.66). This effect was consistent across various subgroups according to different variables, including old age, AMI, advanced KI, high-risk category, left ventricular systolic dysfunction, and multivessel disease. Conclusively, KPS may reduce the CA-AKI risk in high-risk patients with moderate-to-advanced KI who have undergone cardiac catheterization.<\/jats:p>","DOI":"10.1371\/journal.pone.0312618","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T17:40:56Z","timestamp":1729791656000},"page":"e0312618","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Kidney protection strategy lowers the risk of contrast-associated acute kidney injury"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7515-6216","authenticated-orcid":true,"given":"Chien-Boon","family":"Jong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui-Cheng","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Chuan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"pone.0312618.ref001","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.jcin.2021.11.026","article-title":"Long-term clinical impact of contrast-associated acute kidney injury following PCI: an ADAPT-DES substudy","volume":"15","author":"R Mohebi","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"pone.0312618.ref002","first-page":"223","article-title":"Impact of acute 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