Acute Kidney Injury Predicts Heart Failure

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In a study of hospitalized US veterans, AKI was associated with a 23% increased risk of heart failure compared with the absence of AKI.
In a study of hospitalized US veterans, AKI was associated with a 23% increased risk of heart failure compared with the absence of AKI.

Acute kidney injury (AKI) is an independent predictor of incident heart failure, researchers concluded.

Nisha Bansal, MD, of the Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, and colleagues studied a national cohort of 300,868 hospitalized US veterans with no history of heart failure. They defined AKI as a 0.3 mg/dL or 50% increase in serum creatinine level from baseline to the peak hospital value. They matched patients with and without AKI according to 28 inpatient and outpatient covariates. The investigators defined incident heart failure as 1 or more hospitalizations or 2 or more outpatient visits with a diagnosis of heart failure within 2 years through 2013.

The study had 150,434 matched patient pairs. The patients had a median preadmission estimated glomerular filtration rate of 69 mL/min/1.73 m2. The overall incidence rate of heart failure was 27.8 per 1000 person-years. The incidence rate was 30.8 per 1000 person-years in the AKI group compared with 24.9 per 1000 person-years in the non-AKI group, Dr Bansal and colleagues reported online ahead of print in the American Journal of Kidney Diseases. On multivariable analysis, AKI was associated with a significant 23% increased risk for incident heart failure.

Study limitations included a cohort consisting mostly of men seen at Veterans Affairs hospitals.

Reference

Bansal N, Matheny ME, Greevy RA Jr, et al. Acute kidney injury and risk of incident heart failure among US veterans. Am J Kidney Dis. 2017; published online ahead of print.

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