Community-Acquired Acute Kidney Injury as a Risk Factor of de novo Heart Failure Hospitalization
| Autor: | Aasim Afzal, Kristen M. Tecson, Peter A. McCullough, Helen Hashemi, Timothy Gong, Parag Kale |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology 030232 urology & nephrology Primary care Cardiorenal syndrome 030204 cardiovascular system & hematology urologic and male genital diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Internal medicine medicine Humans Risk factor Retrospective Studies Heart Failure Creatinine Primary Health Care business.industry Acute kidney injury Acute Kidney Injury Middle Aged medicine.disease female genital diseases and pregnancy complications Hospitalization chemistry Heart failure Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiorenal medicine. 9(4) |
| ISSN: | 1664-5502 |
| Popis: | Objectives: Because patients with hospital-acquired acute kidney injury (AKI) are at risk for subsequent development of heart failure (HF) and little is known about the relation between community-acquired AKI (CA-AKI) and HF, we sought to determine if CA-AKI is a risk factor for incident HF hospitalization. Methods: We utilized Baylor Scott & White Health databases at the primary care and inpatient hospitalization levels to identify adults without a prior history of HF who had 2 or more serum creatinine measurements within 13 months in the primary care setting. We defined CA-AKI as a serum creatinine increase ≥0.3 mg/dL or ≥1.5 times the baseline for consecutive values within a 13-month period. We created a flag for de novo HF hospitalization at 90, 180, and 365 days following CA-AKI evaluation. Results: In the analyses, 210,895 unique adults were included, of whom 5,358 (2.5%) had CA-AKI. Those with CA-AKI had higher rates of comorbidities, higher rate of males (48 vs. 42%, p < 0.001), and were older (61.5 [50.3, 73.1] vs. 54.1 [42.8, 64.7] years, p < 0.001) than those who did not have CA-AKI. In total, 607 (0.3%), 833 (0.4%), and 1,089 (0.5%) individuals had an incident HF hospitalization in the 90, 180, and 365 days following the CA-AKI evaluation, respectively. After adjusting for demographic and clinical characteristics, patients with CA-AKI had >2 times the risk of de novo HF hospitalization compared with patients who did not have CA-AKI (90 days: 2.35 [1.83–3.02], p < 0.001; 180 days: 2.52 [2.04–3.13], p < 0.001; 365 days: 2.16 [1.77–2.64], p < 0.001). These multivariable models yielded strong predictive abilities, with the areas under the receiver-operating characteristic curve >0.90. Conclusion: After controlling for baseline and clinical characteristics, patients with CA-AKI were at approximately twofold the risk of de novo HF hospitalization (within 90, 180, and 365 days) compared with those who did not have CA-AKI. Hence, detecting CA-AKI may provide an opportunity for early intervention at the primary care level to possibly delay HF development. |
| Databáze: | OpenAIRE |
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