Acute KI and HF have additive effect on mortality in hospitalized patients: study

Acute kidney injury (AKI), also known as acute renal failure (ARF), is a sudden episode of kidney failure or kidney damage that happens within a few hours or a few days. AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body.

Heart failure occurs when your heart can't pump enough blood to meet your body's demand. This can be chronic, meaning it happens slowly over time. Or it can be acute, meaning it happens suddenly. According to a 2014 study, approximately 26 million people worldwide were living with heart failure at the time. In the United States, heart failure is a major cause of people over 65 being admitted to the hospital. This may be because people are living longer with heart disease, which can lead to heart failure over time.

Organ crosstalk between kidney and heart has been suggested. This study aimed to investigate the additive effect of both conditions on mortality. The researchers retrospectively recruited 102,721 hospitalized patients for 5 years. Acute kidney injury was diagnosed with serum creatinine-based criteria, and acute heart failure with International Classification of Diseases code, within two weeks after admission. Primary outcome was all-cause mortality.

The Results of the study are:

Among the 5,316 (5.2%) patients who died, 20.5% died within 1 month. Hazard ratio for 1-month mortality was 23.25 in patients with both conditions, 13.47 for acute kidney injury only, and 2.76 for acute heart failure only. The relative excess risk of interaction was 8.01, and it was more prominent in patients aged <75 years, and those without chronic heart failure.

Thus, the researchers concluded that acute kidney injury and acute heart failure had a detrimental additive effect on short-term mortality in hospitalized patients.

Reference:

Additive Harmful Effects of AKI and Acute Heart Failure on Mortality in Hospitalized Patients by Hyung Eun Son et al. published in the Kidney Weekly E-posters.