Acute Kidney Injury Worse Than MI for Heart, Kidneys

Patients hospitalized with AKI experienced more adverse renocardiovascular events.
Patients hospitalized with AKI experienced more adverse renocardiovascular events.

A recent study indicates that patients with acute kidney injury (AKI) later experience more major cardiac and renal problems than do patients who suffer a myocardial infarction (MI).

In an analysis of 36,980 patients in the Veterans Affairs data base with a discharge diagnosis of AKI or MI (mean age 66.8 years), patients were classified into three groups based on the index admission diagnosis and serum creatinine values: AKI, MI, or AKI with MI. Nearly all patients were male (98.5%), 18.7% were African American, and 73.6% were white.

Lengths of stay for the index admission were longest in the group of patients with AKI plus MI, and shortest in the MI-only group. Baseline estimated glomerular filtration rates were lower among the patients with AKI alone than in the other two groups.

Death occurred most frequently among those who had been admitted with both AKI and MI and least frequently among those with uncomplicated MI admission. In both the unadjusted and adjusted time-to-event analyses, patients with AKI had worse long-term outcomes in terms of major adverse renocardiovascular events than patients with MI alone.

“Poor outcomes associated with [AKI] exceed those of an MI, a disease that carries a much higher public health profile, and whose prevention attracts very high levels of government and nongovernment funding,” Lakhmir Chawla, MD, of George Washington University and the Veterans Affairs Medical Center, both in Washington, DC, and colleagues reported online ahead of print in the Clinical Journal of the American Society of Nephrology.

AKI is one of the most common and serious complications among hospitalized patients, with an incidence that is increasing, the authors noted.

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