Prevalence, Risk factors and Nursing Roles in Preventing the Contrast Associated Acute Kidney Injury (CA-AKI) in older Patients with STEMI Undergoing Percutaneous Coronary Intervention: An Integrative review

Abstract

The purpose of this integrative review was to investigate the prevalence, risk factors, and nursing roles in preventing contrast-associated acute kidney injury (CA-AKI) in older STEMI patients undergoing percutaneous coronary intervention. Cooper's method was employed to collect the data, and keywords were mainly used to search the database from 2000 to 2020 which resulted in 10 articles out of a total of 22 articles that met the requirements. Moreover, the majority of them were based on international situations, and only one article was undertaken in Thailand. Based on the results, the study identified three crucial issues. First, depending on the keywords used in the selected articles, the CA-AKI prevalence ranged from 0.37 to 27.3. Second, the key risk factors included age, female gender, anemia, CHF, DM, serum creatinine levels, and hypotension. Additionally, the level of contrast media and liquid received during the medical procedure was taken into consideration. Moreover, six risk factors are examined collectively such as age, serum creatinine levels, hypotension, CHF DM, and contrast media levels.  However, the factors regarding gender, the drugs, and fluids taken before to the treatment, and the estimated Glomerular Filtration Rate (eGFR) still need more research.  Finally, only two studies examining the roles of nurses in preventing acute kidney failure focused on preventative approaches rather than intervention. Assessing the patients' risk factors and urging them to drink more water were two of the preventative approaches. Additionally, by calculating the correct contrast media intensity level, improving staff communication, and closely watching patients following interventional procedures, it was feasible to reduce the incidence of acute kidney failure by 21%. In conclusion, the samples showed a wide range in the tendency for acute kidney failure, and it was advised that nurses in charge of patient care be aware of the factors relating to patients and medical procedures as well as understand the significance of disease prevention in order to reduce the incidence of acute kidney failure.