{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:14:06Z","timestamp":1774275246634,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic kidney disease (CKD) is associated with severe coronary calcification and increased procedural risks. We aimed to evaluate the impact of CKD on contrast-induced nephropathy (CIN), bleeding, and clinical outcomes in patients undergoing rotational atherectomy (RA). Materials and Methods: This study retrospectively analyzed 652 patients who underwent RA for calcified coronary lesions from the multicenter ROCK registry and a single-center extension between 2010 and 2025. Patients were classified into CKD (eGFR &lt; 60 mL\/min\/1.73 m2, n = 66) and non-CKD (n = 586) groups, excluding those on dialysis. The primary endpoint was a composite of CIN and in-hospital bleeding. Secondary endpoints included 3-year target vessel failure (TVF), myocardial infarction (MI), and total bleeding. Results: The primary composite outcome occurred more frequently in the CKD group (16.7% vs. 5.1%, p = 0.001). Specifically, CIN was significantly higher in CKD patients (15.2% vs. 1.7%, p &lt; 0.001), while in-hospital bleeding did not differ significantly. In multivariate analysis, CKD was an independent predictor of the primary outcome (adjusted OR 3.02; 95% CI 1.36\u20136.69; p = 0.006). At 3-year follow-up, total bleeding (10.6% vs. 3.9%, p = 0.008) and MI (6.1% vs. 2.1%, p = 0.024) were higher in the CKD group, whereas TVF and cardiac death showed no significant difference. Conclusions: CKD is a robust independent risk factor for CIN and long-term bleeding in patients undergoing RA. However, comparable clinical efficacy outcomes suggest that RA remains a feasible strategy in CKD patients when early complications are carefully managed with contrast-minimizing strategies.<\/jats:p>","DOI":"10.3390\/medicina62030597","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:07:06Z","timestamp":1774271226000},"page":"597","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Chronic Kidney Disease on Contrast-Induced Nephropathy, Bleeding, and Clinical Outcomes After Rotational Atherectomy: A Multicenter Retrospective Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-7559","authenticated-orcid":false,"given":"Jaeyun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Nephrology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4380-5314","authenticated-orcid":false,"given":"Jin","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6366-0143","authenticated-orcid":false,"given":"Sang-Suk","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1548-4154","authenticated-orcid":false,"given":"Sung-Ho","family":"Her","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-5503","authenticated-orcid":false,"given":"Kyusup","family":"Lee","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"},{"name":"Department of Cardiology, Daejeon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 34943, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5425-1102","authenticated-orcid":false,"given":"Ki-Dong","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2726-3209","authenticated-orcid":false,"given":"Keon-Woong","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donggyu","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su-Nam","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1244-5691","authenticated-orcid":false,"given":"Won-Young","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea"},{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9996-2346","authenticated-orcid":false,"given":"Ik-Jun","family":"Choi","sequence":"additional","affiliation":[{"name":"Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"},{"name":"Department of Cardiology, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-7760","authenticated-orcid":false,"given":"Jae-Hwan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology in Internal Medicine, Chungnam National University School of Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7101-0236","authenticated-orcid":false,"given":"Jang-Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Rok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-5952","authenticated-orcid":false,"given":"Seung-Whan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4911-8854","authenticated-orcid":false,"given":"Kyeong-Ho","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan 54538, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1260-0778","authenticated-orcid":false,"given":"Hyun-Jong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sejong General Hospital, Bucheon 14754, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1053\/j.ajkd.2004.07.022","article-title":"Coronary artery calcification in patients with CRF not undergoing dialysis","volume":"44","author":"Russo","year":"2004","journal-title":"Am. 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Medicina, 61.","DOI":"10.3390\/medicina61020211"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/597\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:41:24Z","timestamp":1774273284000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,21]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["medicina62030597"],"URL":"https:\/\/doi.org\/10.3390\/medicina62030597","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,21]]}}}