Dialysis-Requiring AKI Imposes Long-Term Heart Risks

Patients found to have a 67% increased risk of coronary events or death.
Patients found to have a 67% increased risk of coronary events or death.

Acute kidney injury (AKI) may raise a patient's risk for future coronary events, according to findings from a study of hospitalized patients who recovered from dialysis-requiring AKI.

The incidence rate of AKI in hospitalized patients is on the rise, but relatively little attention has been paid to the link between AKI and long-term risk of adverse coronary events, Vin-Cent Wu, MD, PhD, of National Taiwan University Hospital in Taipei City, Taiwan, and colleagues noted in their report for Journal of the American Society of Nephrology. To explore this association, the team reviewed data from hospitalized patients in Taiwan who required, and recovered from, AKI requiring dialysis between 1999 and 2008.

Among 17,106 acute dialysis patients who were discharged, 4,869 recovered from dialysis-requiring AKI. Upon matching these individuals with 4,869 patients without AKI, the researchers found that incidence rates of coronary events were 19.8 per 1,000 person-years in the AKI-recovery group versus 10.3 per 1,000 person-years in the non-AKI group. Compared with the non-AKI group, patients who recovered from AKI had a 67% greater risk of experiencing coronary events or of dying during the study period, independent of the effects of subsequent progression to chronic kidney disease and end-stage renal disease.

Post-discharge risk of coronary events in persons with AKI were similar to that seen in patients with diabetes, suggesting that dialysis-requiring AKI with subsequent recovery should be considered a risk category for cardiovascular disease.

Enhanced post-discharge follow-up of renal function of patients who have recovered from temporary dialysis may be warranted, Dr. Wu's group concluded.

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