Risk factors of acute kidney injury in patients with acute heart failure / 中华急诊医学杂志

ABSTRACT

Objective To explore the risk factors for acute kidney injury (AKI) in patients with acute heart failure (AHF).Methods A total of 254 patients with AHF admitted in the emergency department of Peking University People's Hospital from January 2015 to September 2016 were enrolled for retrospective study.Exclusion criteria included:age ＜ 18 years old,end stage renal disease or long-term dialysis,length of hospital stay ＜ 2 days,only one renal function test available during hospitalization,patients discharged by themselves and lacking essential medical records.Data of demographics,past medical history,general conditions at admission,accessory examinations and treatments,etc,were collected.Patients were divided into AKI group and non-AKI group according to Kidney Disease:Improving Global Outcomes (KDIGO) criteria.Univariate comparison analyses were performed to evaluate the differences between the two groups.Results Of 254 eligible patients,there were 78 (30.7％) in AKI group and 176 (69.3％) in non-AKI group.The mortality rates of AKI group and non-AKI group were 34.6％ and 11.9％ (P ＜ 0.05),respectively.Compared with the non-AKI group,baseline serum creatinine,C-reactive protein,the peak level of B-type natriuretic peptide,the proportion of proteinuria,cardiac function grade Ⅳ,the daily dose of intravenous furosemide dose ≥ 80 mg,the use of nesiritide,cardiac inotropic agents and renal replacement therapy in the AKI group were significantly higher;the estimated glomerular filtration rate was significantly lower (P ＜ 0.05).Conclusions The incidence of AKI in patients with AHF was high and the prognosis of patients with AHF developing to AKI was poor.The baseline serum creatinine,estimated glomerular filtration rate,proteinuria,C-reactive protein,cardiac function grade Ⅳ,the peak level of B-type natriuretic peptide,the daily dose of intravenous furosemide dose ≥ 80 mg,the use of nesiritide,cardiac inotropic agents and renal replacement therapy were the significant risk factors of AKI in patients with AHF.