Late Kidney Injury After Admission to Intensive Care Unit for Acute Heart Failure

IF 1.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

International heart journal Pub Date : 2024-05-31 DOI:10.1536/ihj.23-603

Masaki Morooka, Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Shota Shigihara, Suguru Nishigoori, Tomofumi Sawatani, Kenichi Tani, Kazutaka Kiuchi, Shohei Kawakami, Yu Michiura, Shogo Kamitani, Nobuaki Kobayashi, Kuniya Asai

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引用次数: 0

Abstract

Late kidney injury (LKI) in patients with acute heart failure (AHF) requiring intensive care is poorly understood.

We analyzed 821 patients with AHF who required intensive care. We defined LKI based on the ratio of the creatinine level 1 year after admission for AHF to the baseline creatinine level. The patients were categorized into 4 groups based on this ratio: no-LKI (< 1.5, n = 509), Class R (risk; ≥ 1.5, n = 214), Class I (injury; ≥ 2.0, n = 78), and Class F (failure; ≥ 3.0, n = 20). Median follow-up after admission for AHF was 385 (346-426) days. Multivariate logistic regression analysis revealed that acute kidney injury (AKI) during hospitalization (Class R, odds ratio [OR]: 1.710, 95% confidence interval [CI]: 1.138-2.571, P = 0.010; Class I, OR: 6.744, 95% CI: 3.739-12.163, P < 0.001; and Class F, OR: 9.259, 95% CI: 4.078-18.400, P < 0.001) was independently associated with LKI. Multivariate Cox regression analysis showed that LKI was an independent predictor of 3-year all-cause death after final follow-up (hazard ratio: 1.545, 95% CI: 1.099-2.172, P = 0.012). The rate of all-cause death was significantly lower in the no-AKI/no-LKI group than in the no-AKI/LKI group (P = 0.048) and in the AKI/no-LKI group than in the AKI/LKI group (P = 0.017).

The incidence of LKI was influenced by the presence of AKI during hospitalization, and was associated with poor outcomes within 3 years of final follow-up. In the absence of LKI, AKI during hospitalization for AHF was not associated with a poor outcome.

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急性心力衰竭患者入住重症监护室后的晚期肾损伤

我们对 821 名需要接受重症监护的急性心力衰竭（AHF）患者进行了分析。我们根据急性心力衰竭患者入院一年后的肌酐水平与基线肌酐水平之比来定义晚期肾损伤。根据这一比率将患者分为 4 组：无 LKI（< 1.5，n = 509）、R 级（风险；≥ 1.5，n = 214）、I 级（损伤；≥ 2.0，n = 78）和 F 级（失败；≥ 3.0，n = 20）。AHF入院后的中位随访天数为385（346-426）天。多变量逻辑回归分析显示，住院期间的急性肾损伤（AKI）（R 级，几率比 [OR]：1.710，95% 置信区间 [CI]：1.138-2.571，P = 0.010；I 级，OR：6.744，95% CI：3.739-12.163，P <；0.001；F 级，OR：9.259，95% CI：4.078-18.400，P <；0.001）与 LKI 独立相关。多变量 Cox 回归分析显示，LKI 是最终随访后 3 年全因死亡的独立预测因素（危险比：1.545，95% CI：1.099-2.172，P = 0.012）。无AKI/无LKI组的全因死亡率明显低于无AKI/LKI组（P = 0.048），AKI/无LKI组的全因死亡率明显低于AKI/LKI组（P = 0.017）。在没有LKI的情况下，AHF住院期间的AKI与不良预后无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International heart journal 医学-心血管系统

CiteScore

2.50

自引率

6.70%

发文量

148

审稿时长

6-12 weeks

期刊介绍： Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.