Clinical variants of acute kidney injury in decompensated chronic heart failure: prevalence, severity and outcomes


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim. Estimation of prevalence, severity, clinical variants and outcomes of acute kidney injury (Akin) in patients, hospitalized with acute decompensation of chronic heart failure. Methods. і83 patients with acute decompensation of chronic heart failure (age 68,9 ± 9,4 years, arterial hypertension in 87%, coronary heart disease in 56%, myocardial infarction in 53%, chronic heart failure in 56%, diabetes mellitus type 2 in 36%, anemia in 20%) were included into the study. akin prevalence was assessed according to KDIGO recommendations (2012). Results. akin was found 4і% of patients; in 55% of them akin was transient. 63% of patients with akin had previous chronic kidney disease. In 56% of patients akin was diagnosed retrospectively accornidng to decrease of creatininemia during hospitalization. akin in acute decompensation of chronic heart failure is associated with unfavorable outcomes: INCREASE in mortality during first 30 days (17% vs 0% in patients without akin) and in frequency of hospitalizations due to chronic heart failure decompensation (48% vs 37% in patients without akin). Conclusion. Acute kidney injury in acute decompesation of chronic heart failure is associated with significant decrease in prognosis.

Full Text

Restricted Access

References

  1. Мухин Н.А., Моисеев В.С. Кардиоренальные соотношения и риск сердечно-сосудистых заболеваний//Вестник РАМН. — 2003; 11: 50—55.
  2. Мухин Н.А., Моисеев В.С., Кобалава Ж.Д. и др. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе заболеваний сердечно-сосудистой системы и почек // Тер. архив. — 2004; 6: 39—46.
  3. Кобалава Ж. Д., Моисеев В.С. Кардиоренальный синдром // Клин. фармакология и терапия. — 2002; 3:16—18.
  4. Кобалава Ж.Д., Моисеев В.С. Концепция кардиоренальных и метаболических соотношений в современной профилактической кардиологии // Кардиоваскулярная терапия и профилактика. — 2008; 4: 4-7.
  5. Кобалава Ж.Д., Виллевальде С.В., Ефремовцева М.А. и др. Кардиоренальные взаимоотношения: современные представления // Кардиоваскулярная терапия и профилактика. — 2010; 4: 4-11.
  6. Ronco С., Cicoira M., McCullough P.A. Cardiorenal Syndrome Type 1. Pathophysiological Crosstalk Leading to Combined Heart and Kidney Dysfunction in the Setting of Acutely Decompensated Heart Failure // J Am Coll Cardiol. - 2012; 60: 1031-1042.
  7. Adams K.F. Jr., Fonarow G.C., Emerman C.L et al. ADHERE Scientific Advisory Committee and Investigators. Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE) // Am Heart J. 2005. — 149: 209—216.
  8. Fonarow G., Stough W., Abraham W. et al. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: a report from the OPTIMIZE-HF registry // J Am Coll Cardiol. - 2007; 50: 768- 777.
  9. Fonarow G.C., Heywood J.T., Heidenreich P.A. et al. Temporal trends in clinical characteristics, treatments, and outcomes for heart failure hospitalizations, 2002 to 2004: findings from Acute Decompensated Heart Failure National Registry (ADHERE) //Am Heart J. - 2007; 153(6): 1021-1028.
  10. Zhou Q., Zhao C., Xie D. et al. Acute and acute-on-chronic kidney injury of patients with decompensated heart failure: impact on outcomes // BMC Nephrology. - 2012; 13:51, http://www.biomedcentral.com/1471-2369/13/51.
  11. Cowie M.R., Komajda M., Murray-Thomas T. et al. Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH) // Eur Heart J. - 2006; 27(10): 1216-1222.
  12. Krumholz H.M., Chen YA.T., Vaccarino V. et al. Correlates and impact on outcomes of worsening renal function in patients > 65 years of age with heart failure //Am J Cardiol - 2000; 85 (9): 1110-1113.
  13. Jose P., Skali H., Anavekar N. et al. Increase in creatinine and cardiovascular risk in patients with systolic dysfunction after myocardial infarction // J Am Soc Nephrol. - 2006; 17 (10): 2886-2891.
  14. Bellomo R., Ronco C., Kellum J. et al. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group // Crit. Care. - 2004; 8: R204-R212.
  15. Mehta R., Kellum J., Shah S. et al. Acute Kidney Injury Network (AKIN): report of an initiative to improve outcomes in acute kidney injury // Crit Care. -2007; 11: R31.
  16. KDIGO Clinical practice guideline for acute kidney injury // Kidney Int. -2012; 2(1): 1-141.
  17. Национальные рекомендации ВНОК и ОССН по диагностике и лечению хронической сердечной недостаточности (третий пересмотр) // Сердечная Недостаточность. - 2010; 11(1): 69-160.
  18. Levey A.S., Stevens L.A., Schmid C.H. et al., CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate//Ann Intern Med. - 2009; 150(9): 604-612.
  19. Ronco C., Costanzo M.R., Bellomo R. et al. Fluid overload. Diagnosis and management // Contrib Nephrology. - 2011. Vol. 164.
  20. Klein L., Massie B.M., Leimberger J.D. et al. Admission for changes in renal function during hospitalization for worsening heart failure predicts postdischarge survival. Results from the Outcomes of a Prospective Trial of Intravenous Milrinone for exacerbations of Chronic Heart Failure (OPTIME-CHF) // Circulation: Heart Failure. - 2008; 1: 25-33.
  21. Forman D.E., Butler J., Wang Y. et al. Incidence, predictors at admission, and impact of worsening of renal function among patients hospitalized with heart failure // J Am Coll Cardiol - 2004; 43(1): 61-67.
  22. Gottlieb S.S., Abraham W., Butler J. et al. The prognostic importance of different definitions of worsening renal function in congestive heart failure // J Card Fail. - 2002; 8:136-141.
  23. Smith G.L., Vaccarino V., Kosiborod M. et al. Worsening renal function: what is a clinically meaningful change in creatinine during hospitalization with heart failure?// J Card Fail. - 2003; 9:13-25.
  24. Shirakabe A., Hata N., Kobayashi N. et al. Prognostic impact of acute kidney injury inpatients with acute decompensated heart failure// Circulationjournal. - 2012. https://wwwjstagejst.go.jp/article/circj/advpub/0/advpub_CJ-12-0994/_article
  25. Bock J.S., Gottlieb S.S. Cardiorenal Syndrome: New Perspectives // Circulation. - 2010; 121: 2592-2600.
  26. Hillege H.L., Nitsch D., Pfeffer M.A. et al. Renal dysfunction as a predictor of outcome in a broad spectrum of patients with heart failure // Circulation. -2006; 113 (5): 671-678.
  27. Kociol R.D., Greiner M.A., Hammill B.G. et al. Long-term outcomes of medicare beneficiaries with worsening renal function during hospitalization for heart failure // Am J Cardiol. - 2010; 105:1786-1793.
  28. Latchamsetty R., Fang J., Kline-Rogers E. et al. Prognostic value of transient and sustained increase in in-hospital creatinine on outcomes of patients admitted with acute coronary syndrome//Am J Cardiol. - 2007; 99 (7): 939-942.
  29. Patel U.D., Greiner M.A., Fonarow G.C. et al. Associations between worsening renal function and 30-day outcomes among Medicare beneficiaries hospitalized with heart failure // Am Heart J. - 2010; 160: 132-138.e1.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies