Prognostic significance of acute kidney injury and small increases in creatinine concentration during acute decompensation of heart failure

2020 ◽  
Vol 220 (9) ◽  
pp. 561-568
Author(s):  
C. Josa-Laorden ◽  
I. Giménez-López ◽  
J. Rubio-Gracia ◽  
V. Garcés Horna ◽  
M. Sánchez-Marteles ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Prognostic Significance ◽  
Kidney Injury ◽  
Creatinine Concentration ◽  
Acute Decompensation

P787Long-term prognostic value of the combination of fibrosis-4 index and acute kidney injury in patients with admitted for acute decompensated heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Yamada ◽  
T Morita ◽  
Y Furukawa ◽  
S Tamaki ◽  
M Kawasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Acute Decompensated Heart Failure ◽  
Prognostic Significance ◽  
Liver Stiffness ◽  
Total Mortality ◽  
Kidney Injury ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Nitrogen Levels

Abstract Background Liver dysfunction in patients with heart failure (HF) is caused by liver congestion, which is related to liver stiffness. It was reported that liver stiffness assessed by non-invasive fibrosis marker such as Fibrosis-4 (FIB4) index (based on age, aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels, and platelet counts) predicts mortality in HF pts. Acute kidney injury (AKI) during HF treatment is associated with poor outcome in pts admitted for acute decompensated heart failure (ADHF). However, there is no information available on the long-term prognostic significance of the combination of FIB4 index and AKI in ADHF pts. Methods and results We studied 299 ADHF pts with survival discharge. FIB4 index was calculated by the formula: age (yrs) × AST[U/L]/(platelets [103/μL] × (ALT[U/L])1/2). AKI during ADHF treatment was defined according to AKI Network criteria (stage 1: mild, stage 2: moderate, stage 3: severe). During a follow-up period of 4.3±3.3 yrs, 94 pts died. At multivariate Cox analysis, FIB4 index and stage2/3 AKI, but not stage1 AKI, significantly associated with total mortality, independently of prior HF hospitalization and serum sodium and blood urea nitrogen levels after adjustment with BMI, systolic blood pressure, hemoglobin, serum creatinine and albumin levels, left ventricular end-diastolic and left atrial dimension indexes. Pts with both greater FIB4 index (>2.674: median) and stage 2/3 AKI had a significantly higher risk of total mortality than those with none of them. Adjusted hazard ratio in pts with both greater FIB4 index and stage 2/3 AKI was 3.5 (95% CI 1.6–7.7), which was two-fold of that in pts with either of them (1.7 [95% CI 1.1–2.7]). Conclusion The combination of FIB4 index and moderate to severe AKI might identify higher risk subset for total mortality in ADHF pts.

scholarly journals Hypoxia-inducible factor 1 (HIF-1) as a biomarker of acute kidney injury in patients with acute decompensation of chronic heart failure

Kardiologiia ◽  
2019 ◽  
Vol 59 (2S) ◽  
pp. 25-30
Author(s):  
E. V. Efremova ◽  
A. M. Shutov ◽  
E. R. Makeeva ◽  
M. V. Menzorov ◽  
E. R. Sakaeva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Kidney Function ◽  
Filtration Rate ◽  
Hypoxia Inducible Factor ◽  
Kidney Injury ◽  
Hypoxia Inducible Factor 1 ◽  
Acute Decompensation

Actuality.Impaired kidney function adversely influences both immediate and remote prognosis for patients with chronic heart failure (CHF). However, early detection and prediction of acute kidney injury (AKI) are understudied.The aimof study was to investigate hypoxia-inducible factor 1 (HIF-1) as a biomarker for early diagnosis of AKI and determining prognosis in patients with acute decompensated CHF (ADCHF).Materials and methods:84 patients admitted for ADCHF (18 women; mean age, 61.4±7.1) were evaluated. ADCHF was diagnosed in accordance with SEHF guidelines for diagnosis and treatment of chronic heart failure (RCS, 2016). AKI was diagnosed according to KDIGO criteria (2012). HIF-1, N-terminal pro B-type natriuretic peptide (NТ-proBNP), and erythropoietin were measured in blood serum. The follow-up period lasted for 12 months.Results:AKI was diagnosed in 27 (32.1 %) patients. Level of HIF-1 was 1.27±0.63 ng / ml; NТ-proBNP – 2469.6 (interquartile range (IQR), 1312.2; 3300.0) pg / ml; eryhthropoietin – 56.0 mIU / ml (IQR, 13.2; 68.1). No correlation was found between HIF-1 and glomerular filtration rate, NТ-proBNP, or erythropoietin. Differences in biomarker levels were not observed between patients with and without AKI; however, HIF-1 was higher in the group of deceased patients than in the group of survived patients (1.64±0.9 vs. 1.17±0.44 ng / ml, р=0.004), which was not observed for NТ-proBNP and erythropoietin.Conclusion.AKI was observed in every third patient with ADCHF. In ADCHF, HIF-1 was not correlated with the kidney function; however, a relationship was found between the HIF-1 level and prediction for patients with CHF.

scholarly journals Diagnostic and prognostic significance of aberrant miR-652-3p levels in patients with acute decompensated heart failure and acute kidney injury

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096782
Author(s):  
Jiaolei Liu ◽  
Hongmei Zhang ◽  
Xin Li ◽  
Lin Wang ◽  
Huining Yu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Diagnostic Performance ◽  
Acute Decompensated Heart Failure ◽  
Characteristic Curve ◽  
Prognostic Significance ◽  
Kidney Injury ◽  
Decompensated Heart Failure ◽  
Diagnostic Value

Objective This study aimed to examine a novel microRNA (miR-652-3p) biomarker to improve early diagnosis of acute kidney injury (AKI) in patients with acute decompensated heart failure (ADHF) and to evaluate the survival predictive value of miR-652-3p. Methods We retrospectively analyzed the data of 196 patients with ADHF, including 65 who developed AKI during hospitalization. Neutrophil gelatinase-associated lipocalin (NGAL) levels were measured in serum and urine samples. Real-time quantitative PCR was applied to evaluate miR-652-3p mRNA expression. The diagnostic performance of miR-652-3p was examined using receiver operating characteristic curve analysis. The prognostic value of miR-652-3p was also analyzed. Results Serum and urinary NGAL and miR-652-3p levels were elevated in patients with ADHF and AKI. Serum and urinary miR-652-3p expression had diagnostic value in predicting AKI onset in patients with ADHF, and it had improved diagnostic performance when used with NGAL. Patients with AKI and high miR-652-3p levels had a high failure rate of renal recovery and poor 180-day survival. Conclusion Serum and urinary miR-652-3p may be a candidate biomarker for early diagnosis of AKI in patients with ADHF and for predicting the prognosis of AKI. The combination of NGAL and miR-652-3p may accurately predict AKI onset in ADHF.

scholarly journals Predictors of acute kidney injury in patients with acute decompensated heart failure in emergency departments in China

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110162
Author(s):  
Hongxia Ge ◽  
Yang Liang ◽  
Yingying Fang ◽  
Yi Jin ◽  
Wenting Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Acute Decompensated Heart Failure ◽  
Kidney Injury ◽  
Decompensated Heart Failure ◽  
Albumin Concentration ◽  
Inotropic Agents ◽  
Creatinine Concentration ◽  
Cardiovascular Comorbidities ◽  
Arterial Ph

Objective This retrospective multicentre observational study was performed to assess the predictors of acute kidney injury (AKI) in patients with acute decompensated heart failure (ADHF) in emergency departments in China. Methods In total, 1743 consecutive patients with ADHF were recruited from August 2017 to January 2018. Clinical characteristics and outcomes were compared between patients with and without AKI. Predictors of AKI occurrence and underdiagnosis were assessed in multivariate regression analyses. Results Of the 1743 patients, 593 (34.0%) had AKI. AKI was partly associated with short-term all-cause mortality and cost. Cardiovascular comorbidities such as coronary heart disease, diabetes mellitus, and hypertension remained significant predictors of AKI in the univariate analysis. AKI was significantly more likely to occur in patients with a lower arterial pH, lower albumin concentration, higher creatinine concentration, and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration. Patients treated with inotropic agents were significantly more likely to develop AKI during their hospital stay. Conclusion This study suggests that cardiovascular comorbidities, arterial pH, the albumin concentration, the creatinine concentration, the NT-proBNP concentration, and use of inotropic agents are predictors of AKI in patients with ADHF.

scholarly journals Acute kidney injury worsens outcomes in acute decompensation of chronic heart failure

2017 ◽  
Vol 8 (4) ◽  
pp. 11-14
Author(s):  
V. V Davydov ◽  
E. L Arekhina ◽  
M. S Tarasova
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Cardiovascular Diseases ◽  
Chronic Heart Failure ◽  
Kidney Injury ◽  
Acute Decompensation ◽  
Heart Failure Decompensation

Acute kidney injury was 33.6% of patients had acute decompensation of chronic heart failure. This complication has increased the number of cardiovascular diseases, relapses of chronic heart failure decompensation and mortality during the next 12 months.

Rhabdomyolysis, Acute Kidney Injury, and a Novel Frameshift Mutation in a Child with Glutaric Acidemia Type I

Nephron ◽  
2021 ◽  
pp. 1-6
Author(s):  
Linlin Huang ◽  
Ting Shi ◽  
Ying Li ◽  
Xiaozhong Li
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Frameshift Mutation ◽  
Novel Mutation ◽  
Kidney Injury ◽  
Febrile Illness ◽  
Type I ◽  
Continuous Venovenous Hemodiafiltration ◽  
Glutaric Acidemia Type I ◽  
Acute Decompensation

This is a case report of a girl with glutaric acidemia type I (GA-I) who experienced rhabdomyolysis and acute kidney injury (AKI). Her first acute metabolic crisis occurred at the age of 5 months, which mainly manifested as irritable crying, poor appetite, and hyperlactatemia. Mutation analysis showed 2 pathogenic mutations in the glutaryl-CoA dehydrogenase (GCDH) gene, which were c.383G>A (p.R128Q) and c.873delC (p.N291Kfs*41), the latter of which is a novel frameshift mutation of GA-I. She had a febrile illness at the age of 12 months, followed by AKI and severe rhabdomyolysis. Four days of continuous venovenous hemodiafiltration (CVVHDF) helped to overcome this acute decompensation. This case report describes a novel mutation in the GCDH gene, that is, c.873delC (p.N291Kfs*41). Also, it highlights the fact that patients with GA-I have a high risk of rhabdomyolysis and AKI, which may be induced by febrile diseases and hyperosmotic dehydration; CVVHDF can help to overcome this acute decompensation.

scholarly journals A simple nomogram to predict contrast-induced acute kidney injury in patients with congestive heart failure undergoing coronary angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Lei ◽  
Y He ◽  
Z Guo ◽  
B Liu ◽  
J Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Prediction Models ◽  
Validation Cohort ◽  
Kidney Injury ◽  
Class Ii ◽  
Functional Class ◽  
Killip Class

Abstract Background Patients with congestive heart failure (CHF) are vulnerable to contrast-induced acute kidney injury (CI-AKI), but few prediction models are currently available. Objectives We aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results The incidence of CI-AKI was 9.06% (n=170) in the total sample, 8.64% (n=109) in the development cohort and 9.92% (n=61) in the validation cohort (p=0.367). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs 0.75, p=0.061), as well as a well-fitted calibration curve. Conclusions The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed. Figure 1 Funding Acknowledgement Type of funding source: None

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