This is the retrospective study regarding the association of invasive coronary angiography and time to renal replacement therapy initiation and mortality in patients with chronic kidney disease stage 4-5 who develop acute coronary syndrome.

Electronic medical records of adult patients admitted with ACS, by the recorded diagnosis code, between 1 January 2017 and 31 December 2021 at King Chulalongkorn Memorial Hospital, Thailand, were retrospectively reviewed. Eligible patients should have concurrent advanced stage CKD, defined as an eGFR less than 30 mL/min/1.73 m² calculated by the 2021 CKD-EPI creatinine equation.

Inclusion Criteria:

• Advanced stage CKD, defined as an eGFR less than 30 mL/min/1.73 m²
• Diagnosis with ACS, by the recorded diagnosis code, between 1 January 2017 and 31 December 2021 at King Chulalongkorn Memorial Hospital

Exclusion Criteria:

• Received maintenance dialysis or kidney transplantation before admission
• Cardiogenic shock or cardiac arrest
• Prior PCI or CABG within 12 months
• Recently diagnosed with ACS within 2 months
• Had a limited life expectancy due to non-cardiovascular disease
• Pregnant.

Patients with pre-dialysis CKD stage 4-5 with acute coronary syndrome

All data generated or analyzed during this study are included in this article.