Impact of onset time of acute kidney injury on outcomes in patients with acute decompensated heart failure

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• 作者：Yoichi Takaya ; Fumiki Yoshihara ; Hiroyuki Yokoyama ; Hideaki Kanzaki…
• 关键词：Acute decompensated heart failure ; Acute kidney injury ; Onset time ; Prognosis
• 刊名：Heart and Vessels
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：31
• 期：1
• 页码：60-65
• 全文大小：395 KB
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• 作者单位：Yoichi Takaya (1)
  Fumiki Yoshihara (2)
  Hiroyuki Yokoyama (1)
  Hideaki Kanzaki (1)
  Masafumi Kitakaze (1)
  Yoichi Goto (1)
  Toshihisa Anzai (1)
  Satoshi Yasuda (1)
  Hisao Ogawa (1)
  Yuhei Kawano (2)
  
  1. Department of Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
  2. Department of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573

文摘

Since acute kidney injury (AKI) is not always related to mortality in patients with acute decompensated heart failure (ADHF), the aim of this study was to focus on onset time of AKI and its clinical importance. A total of 371 ADHF patients were included. The impact of AKI (≥0.3 mg/dl or 1.5-fold increase in serum creatinine level within 48 h) with early onset (≤4 days from admission) or late onset (≥5 days from admission) was assessed. AKI occurred in 99 patients, who were divided into two groups according to the median onset time of AKI: 50 with early onset of AKI and 49 with late onset of AKI. The maximum increase in serum creatinine level from admission was greater in patients with late onset of AKI than in patients with early onset of AKI (p = 0.012). Patients with late onset of AKI had a higher 12-month mortality rate than that in patients with early onset of AKI (log-rank test, p = 0.014). Late onset of AKI was an independent predictor of mortality (hazard ratio: 3.39, 95 % confidence interval: 1.84–6.18, p < 0.001). Late onset of AKI was associated with high blood urea nitrogen level at admission and intravenous administration of dobutamine. In conclusion, late onset of AKI related to high blood urea nitrogen level and intravenous administration of dobutamine, but not early onset of AKI, is linked to high mortality rate. Onset time of AKI may be useful for risk stratification of mortality in ADHF patients developing AKI.