Inflammatory burden index and contrast-associated acute kidney injury after iliac artery endovascular intervention: association with renal injury and lesion complexity
- 1Department of Cardiology, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
Abstract
Introduction: Contrast-associated acute kidney injury (CA-AKI) is a complication after peripheral endovascular interventions, but the value of the inflammatory burden index (IBI) in this setting is unknown.
Aim: To evaluate the association between pre-procedural IBI and CA-AKI after iliac artery intervention, compare its performance with other inflammatory indices, and examine its relationship with TASC II lesion complexity.
Material and methods: This retrospective study included 417 patients treated between January 2020 and December 2025. IBI was calculated as C-reactive protein multiplied by the neutrophil-to-lymphocyte ratio. CA-AKI was defined as a serum creatinine increase of ≥ 0.5 mg/dl or ≥ 25% within 72 h. Receiver operating characteristic analysis, DeLong testing, multivariable logistic regression with multiple imputation, restricted cubic splines, and bootstrap validation were performed.
Results: CA-AKI occurred in 70 (16.8%) patients. IBI showed the highest discrimination for CA-AKI (AUC = 0.857, 95% CI: 0.810–0.904), outperforming C-reactive protein, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and aggregate index of systemic inflammation (all p < 0.001). At a cutoff of 40.6, sensitivity and specificity were 80.0% and 80.2%, respectively. Each doubling of IBI was independently associated with CA-AKI (adjusted OR = 3.19, 95% CI: 2.22–4.59; p < 0.001). The association was nonlinear (p for nonlinearity < 0.001). IBI was also independently associated with TASC II C–D lesions (adjusted OR per doubling 2.91, 95% CI: 2.29–3.71; p < 0.001).
Conclusions: Pre-procedural IBI was independently associated with CA-AKI and complex iliac lesion morphology and outperformed the other evaluated inflammatory indices. External validation is required before clinical implementation.
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BibTeX
@article{keten2026inflammatory,
title = {{Inflammatory burden index and contrast-associated acute kidney injury after iliac artery endovascular intervention: association with renal injury and lesion complexity}},
author = {Mustafa Ferhat Keten and Kadir Bıyıklı and Busra Guvendi Sengor and Seda Tanyeri Uzel and Mustafa Furkan Kılıçarslan and Ayşe Nur Küçük and Hasan Karaot and Azmican Kaya and Neşri Danışman and İsmail Balaban},
journal = {Postepy w kardiologii interwencyjnej = Advances in interventional cardiology},
year = {2026},
month = sep,
doi = {10.5114/aic.2026.164982},
url = {https://europepmc.org/article/PMC/PMC13721074},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Inflammatory burden index and contrast-associated acute kidney injury after iliac artery endovascular intervention: association with renal injury and lesion complexity
AU - Mustafa Ferhat Keten
AU - Kadir Bıyıklı
AU - Busra Guvendi Sengor
AU - Seda Tanyeri Uzel
AU - Mustafa Furkan Kılıçarslan
AU - Ayşe Nur Küçük
AU - Hasan Karaot
AU - Azmican Kaya
AU - Neşri Danışman
AU - İsmail Balaban
PY - 2026
DA - 2026/09/01
JO - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology
DO - 10.5114/aic.2026.164982
UR - https://europepmc.org/article/PMC/PMC13721074
AB - Introduction: Contrast-associated acute kidney injury (CA-AKI) is a complication after peripheral endovascular interventions, but the value of the inflammatory burden index (IBI) in this setting is unknown. Aim: To evaluate the association between pre-procedural IBI and CA-AKI after iliac artery intervention, compare its performance with other inflammatory indices, and examine its relationship with TASC II lesion complexity. Material and methods: This retrospective study included 417 patients treated between January 2020 and December 2025. IBI was calculated as C-reactive protein multiplied by the neutrophil-to-lymphocyte ratio. CA-AKI was defined as a serum creatinine increase of ≥ 0.5 mg/dl or ≥ 25% within 72 h. Receiver operating characteristic analysis, DeLong testing, multivariable logistic regression with multiple imputation, restricted cubic splines, and bootstrap validation were performed. Results: CA-AKI occurred in 70 (16.8%) patients. IBI showed the highest discrimination for CA-AKI (AUC = 0.857, 95% CI: 0.810–0.904), outperforming C-reactive protein, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and aggregate index of systemic inflammation (all p < 0.001). At a cutoff of 40.6, sensitivity and specificity were 80.0% and 80.2%, respectively. Each doubling of IBI was independently associated with CA-AKI (adjusted OR = 3.19, 95% CI: 2.22–4.59; p < 0.001). The association was nonlinear (p for nonlinearity < 0.001). IBI was also independently associated with TASC II C–D lesions (adjusted OR per doubling 2.91, 95% CI: 2.29–3.71; p < 0.001). Conclusions: Pre-procedural IBI was independently associated with CA-AKI and complex iliac lesion morphology and outperformed the other evaluated inflammatory indices. External validation is required before clinical implementation.
SN - 1734-9338
SN - 1897-4295
ER -