Factors Associated with the Development of Acute Kidney Injury in Acute Decompensated Heart Failure
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Abstract
Background: Acute decompensated heart failure (ADHF) is a clinical syndrome that often results in hospitalization. Acute kidney injury (AKI) or cardiorenal syndrome type I is common in ADHF patients due to confluent of interrelate abnormality of decrease cardiac performance and renal function. Moreover, development of AKI in ADHF patients is associated with poor prognosis. This study, therefore, aimed to investigate the factors associated with the development of AKI in ADHF.
Objective: To determine factors associated with the development of AKI (cardiorenal type 1) in ADHF patients.
Methods: This is a retrospective study of ADHF patients who were admitted in Bhumibol Adulyadej Hospital, Bangkok between August 2018 to December 2019. Demographic data, clinical data, laboratory findings, and echocardiography data were collected from electronic database. Framingham criteria was used for diagnosing ADHF, while Kidney Disease Improving Global Outcomes (KDIGO) criteria 2012 was used to diagnosis and staging AKI.
Result: 152 patients (age 68.78 ±14.02) diagnosed with ADHF were enrolled in the study. Incidence of AKI stage I, II, and III were 69.7, 11.8, and 18.4%, respectively. Patients with cold type heart failure (p=0.014), mitral regurgitation (p=0.022), chronic kidney disease (CKD) (p=0.034), and the used of beta blockers (p=0.042) was increased risk for AKI. It is important to note that patients who developed AKI were significantly increased risk of intubation (p < 0.001) and death (p=0.001).
Conclusion: In 152 patients with ADHF in Bhumibol Adulyadej Hospital, factors associated with the development of AKI include: cold type heart failure, mitral regurgitation, baseline CKD and the used of beta blockers. Patients who developed AKI has significantly increased risk of death.
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