Tags

Type your tag names separated by a space and hit enter

Acute and acute-on-chronic kidney injury of patients with decompensated heart failure: impact on outcomes.
BMC Nephrol 2012; 13:51BN

Abstract

BACKGROUND

Acute worsening of renal function, an independent risk factor for adverse outcomes in acute decompensated heart failure (ADHF), occurs as a consequence of new onset kidney injury (AKI) or acute deterioration of pre-existed chronic kidney disease (CKD) (acute-on-chronic kidney injury, ACKI). However, the possible difference in prognostic implication between AKI and ACKI has not been well established.

METHODS

We studied all consecutive patients hospitalized with ADHF from 2003 through 2010 in Nanfang Hospital. We classified patients as with or without pre-existed CKD based on the mean estimated glomerular filtration rate (eGFR) over a six-month period before hospitalization. AKI and ACKI were defined by RIFLE criteria according to the increase of the index serum creatinine.

RESULTS

A total of 1,005 patients were enrolled. The incidence of ACKI was higher than that of AKI. The proportion of patients with diuretic resistance was higher among patients with pre-existed CKD than among those without CKD (16.9% vs. 9.9%, P = 0.002). Compared with AKI, ACKI was associated with higher risk for in-hospital mortality, long hospital stay, and failure in renal function recovery. Pre-existed CKD and development of acute worsening of renal function during hospitalization were the independent risk factors for in-hospital death after adjustment by the other risk factors. The RIFLE classification predicted all-cause and cardiac mortality in both AKI and ACKI.

CONCLUSIONS

Patients with ACKI were at greatest risk of adverse short-term outcomes in ADHF. Monitoring eGFR and identifying CKD should not be ignored in patients with cardiovascular disease.

Authors+Show Affiliations

Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22747708

Citation

Zhou, Qiugen, et al. "Acute and Acute-on-chronic Kidney Injury of Patients With Decompensated Heart Failure: Impact On Outcomes." BMC Nephrology, vol. 13, 2012, p. 51.
Zhou Q, Zhao C, Xie D, et al. Acute and acute-on-chronic kidney injury of patients with decompensated heart failure: impact on outcomes. BMC Nephrol. 2012;13:51.
Zhou, Q., Zhao, C., Xie, D., Xu, D., Bin, J., Chen, P., ... Hou, F. (2012). Acute and acute-on-chronic kidney injury of patients with decompensated heart failure: impact on outcomes. BMC Nephrology, 13, p. 51. doi:10.1186/1471-2369-13-51.
Zhou Q, et al. Acute and Acute-on-chronic Kidney Injury of Patients With Decompensated Heart Failure: Impact On Outcomes. BMC Nephrol. 2012 Jul 2;13:51. PubMed PMID: 22747708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute and acute-on-chronic kidney injury of patients with decompensated heart failure: impact on outcomes. AU - Zhou,Qiugen, AU - Zhao,Chunmei, AU - Xie,Di, AU - Xu,Dingli, AU - Bin,Jianping, AU - Chen,Pingyan, AU - Liang,Min, AU - Zhang,Xun, AU - Hou,Fanfan, Y1 - 2012/07/02/ PY - 2011/11/06/received PY - 2012/07/02/accepted PY - 2012/7/4/entrez PY - 2012/7/4/pubmed PY - 2013/5/28/medline SP - 51 EP - 51 JF - BMC nephrology JO - BMC Nephrol VL - 13 N2 - BACKGROUND: Acute worsening of renal function, an independent risk factor for adverse outcomes in acute decompensated heart failure (ADHF), occurs as a consequence of new onset kidney injury (AKI) or acute deterioration of pre-existed chronic kidney disease (CKD) (acute-on-chronic kidney injury, ACKI). However, the possible difference in prognostic implication between AKI and ACKI has not been well established. METHODS: We studied all consecutive patients hospitalized with ADHF from 2003 through 2010 in Nanfang Hospital. We classified patients as with or without pre-existed CKD based on the mean estimated glomerular filtration rate (eGFR) over a six-month period before hospitalization. AKI and ACKI were defined by RIFLE criteria according to the increase of the index serum creatinine. RESULTS: A total of 1,005 patients were enrolled. The incidence of ACKI was higher than that of AKI. The proportion of patients with diuretic resistance was higher among patients with pre-existed CKD than among those without CKD (16.9% vs. 9.9%, P = 0.002). Compared with AKI, ACKI was associated with higher risk for in-hospital mortality, long hospital stay, and failure in renal function recovery. Pre-existed CKD and development of acute worsening of renal function during hospitalization were the independent risk factors for in-hospital death after adjustment by the other risk factors. The RIFLE classification predicted all-cause and cardiac mortality in both AKI and ACKI. CONCLUSIONS: Patients with ACKI were at greatest risk of adverse short-term outcomes in ADHF. Monitoring eGFR and identifying CKD should not be ignored in patients with cardiovascular disease. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/22747708/Acute_and_acute_on_chronic_kidney_injury_of_patients_with_decompensated_heart_failure:_impact_on_outcomes_ L2 - https://www.biomedcentral.com/1471-2369/13/51 DB - PRIME DP - Unbound Medicine ER -