Hospitalized patients with acute kidney injury have increased risk of heart failure

May 18, 2018, Kaiser Permanente

Hospitalized patients who experience acute kidney injury face a 44 percent greater risk of heart failure during their first year after leaving the hospital, according to new Kaiser Permanente research published today in the Clinical Journal of the American Society of Nephrology.

Acute injury is a sudden decline in the ability of the kidneys to perform their normal function of filtering waste products from blood. People who are hospitalized for a wide variety of conditions, from major surgery to severe infection, are at risk for acute kidney injury, which can increase a patient's long-term risk of death even after they are successfully treated and sent home.

"While Kaiser Permanente has had success in lowering rates of acute kidney injury in hospitalized , rates are rising nationwide, and even minor injury is linked to a higher risk of death," said Alan S. Go, MD, director of the Comprehensive Clinical Research Unit within the Kaiser Permanente Northern California Division of Research and lead author of the new study.

Earlier research by Dr. Go and colleagues linked hospitalized acute kidney injury to elevated risk of . In this new study, which adds to that body of work, the research team examined of patients who were admitted to one of Kaiser Permanente's 21 hospitals in Northern California at some point between 2006 and 2013. They investigated whether the risk of various within one year of leaving the hospital differed between patients who experienced acute kidney injury while hospitalized and those who did not.

Out of 146,931 hospitalized patients included in the analysis, 31,245 experienced acute kidney injury. To help ensure an accurate comparison, patients with acute kidney injury were statistically matched to patients without acute kidney injury, according to similar demographics, length of hospital stay, medications they took, how acutely ill they were and other characteristics.

Roughly 1 in 25 people who are hospitalized for any reason will experience heart within a year. The analysis found that even after accounting for remaining differences, patients who have an acute kidney injury during hospitalization experienced a 44 percent higher relative risk of heart failure within one year of discharge, compared to those without acute kidney injury. Rates of other cardiovascular events linked to atherosclerosis (narrowing of the arteries) did not differ significantly between the two groups.

"The number of atherosclerotic events in patients with acute kidney injury was lower than we expected," Dr. Go said. "Overall, our results highlight heart failure as a key risk for patients who experienced acute kidney injury in the hospital."

According to senior author Kathleen D. Liu, MD, Ph.D., of the University of California, San Francisco, the new findings suggest the need for doctors to be more vigilant in looking for signs of heart failure in patients who experienced acute kidney during hospitalization. "Earlier detection of heart failure symptoms in these patients could potentially save lives."

Meanwhile, Dr. Go and others are examining the mechanisms underlying the increased risk. "Kidney damage affects a number of biological pathways, including inflammation and mineral metabolism," Dr. Go said. "If we could understand how these changes increase risk of failure, we may be able to develop new strategies for prevention."

Explore further: Model predicts development of chronic kidney disease

Related Stories

Model predicts development of chronic kidney disease

November 16, 2017
(HealthDay)—A multivariable model that uses routine laboratory data is able to predict advanced chronic kidney disease after hospitalization with acute kidney injury, according to a study published online Nov. 14 in the ...

ASN: Severe acute kidney injury ups risk of 28-day mortality

November 21, 2016
(HealthDay)—Acute kidney injury is associated with increased risk of 28-day mortality among critically ill children and young adults, according to a study published online Nov. 18 in the New England Journal of Medicine. ...

Caffeine found to reduce incidence of acute kidney injury in neonates

April 3, 2018
Preterm neonates who are exposed to caffeine within the first seven days after birth have reduced incidence and severity of acute kidney injuries than neonates who did not, according to findings from the Neonatal Kidney Collaborative's ...

No evidence higher doses of cholesterol-lowering drug increase risk of acute kidney damage

July 31, 2017
New Zealanders taking a higher dose of simvastatin, one of the cholesterol-lowering statin drugs used to prevent heart attacks and strokes, do not appear to have a higher risk of acute kidney damage than those taking a lower ...

Computer program helps doctors detect acute kidney injury earlier to save lives

November 2, 2017
Embedding a decision support tool in the hospital electronic health record increases detection of acute kidney injury, reducing its severity and improving survival, according to new research from the University of Pittsburgh ...

Few patients hospitalized with acute kidney injury receive recommended follow-up care

October 12, 2017
A new study indicates that after hospitalization with acute kidney injury (AKI), most patients are not receiving the follow-up care that kidney specialists recommend. The findings appear in an upcoming issue of the Clinical ...

Recommended for you

Lung-on-a-chip simulates pulmonary fibrosis

May 25, 2018
Developing new medicines to treat pulmonary fibrosis, one of the most common and serious forms of lung disease, is not easy.

Reconstructing Zika's spread

May 24, 2018
The urgent threat from Zika virus, which dominated news headlines in the spring and summer of 2016, has passed for now. But research into how Zika and other mosquito-borne infections spread and cause epidemics is still very ...

Molecular network boosts drug resistance and virulence in hospital-acquired bacterium

May 24, 2018
In response to antibiotics, a gene regulation network found in the bacterium Acinetobacter baumannii acts to boost both virulence and antibiotic resistance. Edward Geisinger of Tufts University School of Medicine and colleagues ...

Tick bite protection: New CDC study adds to the promise of permethrin-treated clothing

May 24, 2018
The case for permethrin-treated clothing to prevent tick bites keeps getting stronger.

Past use of disinfectants and PPE for Ebola could inform future outbreaks

May 24, 2018
Data from the 2014 Ebola virus outbreak at two Sierra Leone facilities reveal daily usage rates for disinfectant and personal protective equipment, informing future outbreaks, according to a study published May 24, 2018 in ...

Early lactate measurements appear to improve results for septic patients

May 24, 2018
On October 1, 2015, the United States Centers for Medicare and Medicaid Services (CMS) issued a bundle of recommendations defining optimal treatment of patients suffering from sepsis, a life-threatening response to infection ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.