Acute kidney disease and acute kidney injury biomarkers in coronary care unit patients

Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (−) 3.04%) and without CKD (CKD (−)/AF (+) 2.32% vs. CKD (−)/AF (−) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications.

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Anion Gap Was Associated with Inhospital Mortality and Adverse Clinical Outcomes of Coronary Care Unit Patients

BioMed Research International ◽

10.1155/2020/4598462 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Tienan Sun ◽

Chenghui Cai ◽

Hua Shen ◽

Jiaqi Yang ◽

Qianyun Guo ◽

...

Keyword(s):

Acute Kidney Injury ◽

Clinical Outcomes ◽

Coronary Care Unit ◽

Kidney Injury ◽

Anion Gap ◽

Independent Effect ◽

Binary Logistic Regression Analysis ◽

Inhospital Mortality ◽

All Cause Mortality ◽

Coronary Care

Background. Anion gap (AG) has been proved to be associated with prognosis of many cardiovascular diseases. This study is aimed at exploring the association of AG with inhospital all-cause mortality and adverse clinical outcomes in coronary care unit (CCU) patients. Method. All data of this study was extracted from Medical Information Mart for Intensive Care III (MIMIC-III, version 1.4) database. All patients were divided into four groups according to AG quartiles. Primary outcome was inhospital all-cause mortality. Lowess smoothing curve was drawn to describe the overall trend of inhospital mortality. Binary logistic regression analysis was performed to determine the independent effect of AG on inhospital mortality. Result. A total of 3593 patients were enrolled in this study. In unadjusted model, as AG quartiles increased, inhospital mortality increased significantly, OR increased stepwise from quartile 2 (OR, 95% CI: 1.01, 0.74-1.38, P=0.958) to quartile 4 (OR, 95% CI: 2.72, 2.08-3.55, P<0.001). After adjusting for possible confounding variables, this association was attenuated, but still remained statistically significant (quartile 1 vs. quartile 4: OR, 95% CI: 1.02, 0.72-1.45 vs. 1.49, 1.07-2.09, P=0.019). Moreover, CCU mortality (P<0.001) and rate of acute kidney injury (P<0.001) were proved to be higher in the highest AG quartiles. Length of CCU (P<0.001) and hospital stay (P<0.001) prolonged significantly in higher AG quartiles. Maximum sequential organ failure assessment score (SOFA) (P<0.001) and simplified acute physiology score II (SAPSII) (P<0.001) increased significantly as AG quartiles increased. Moderate predictive ability of AG on inhospital (AUC: 0.6291), CCU mortality (AUC: 0.6355), and acute kidney injury (AUC: 0.6096) was confirmed. The interactions were proved to be significant in hypercholesterolemia, congestive heart failure, chronic lung disease, respiratory failure, oral anticoagulants, Beta-blocks, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), and vasopressin treatment subgroups. Conclusion. AG was an independent risk factor of inhospital all-cause mortality and was associated with adverse clinical outcomes in CCU patients.

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Biomarkers of acute kidney disease. potential application in practice

Consilium Medicum ◽

10.26442/20751753.2021.1.200729 ◽

2021 ◽

Vol 23 (1) ◽

pp. 15-19

Author(s):

Ekaterina S. Schelkanovtseva ◽

◽

Ekaterina S. Schelkanovtseva ◽

Olga Iu. Mironova ◽

Viktor V. Fomin ◽

...

Keyword(s):

Acute Kidney Injury ◽

Clinical Practice ◽

Kidney Disease ◽

Serum Creatinine ◽

Potential Application ◽

Kidney Injury ◽

Clinical Syndrome ◽

Acute Kidney Disease ◽

Definition Of ◽

New Biomarkers

Acute kidney injury (AKI) is a common clinical syndrome. Its variety of presentation explains the absence of “kidney troponin”. Many research projects of new biomarkers are ongoing now. The enormous number of biomarkers has been identified already. It makes difficult to choose the correct test and dictates the importance of the fastest and most accurate introduction of AKI biomarkers into clinical practice. The integration of appropriately selected biomarkers in routine clinical practice for high-risk patients of AKI is very important. Currently, serum creatinine (sCr) and urine output are used to define AKI in accordance with the definition of KDIGO (Kidney Disease: Improving Global Outcomes), which have a number of significant limitations for practitioners, including the inability to diagnose AKI before serum creatinine levels increase. Practitioners need systematic information about the latest AKI markers and possible situations, when and for which patient groups they can be used. This is the main goal of our review. Keywords: acute kidney injury, biomarkers, NGAL, TIMP-2, IGFBP7, cystatin C, markers, injury, kidney stress For citation: Schelkanovtseva ES, Mironova OIu, Fomin VV. Biomarkers of acute kidney disease. Potential application in practice. Consilium Medicum. 2021; 23 (1): 15–19. DOI: 10.26442/20751753.2021.1.200729

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Incidence and mortality of acute kidney injury in patients with acute coronary syndrome: A retrospective study from a single coronary care unit

Saudi Journal of Kidney Diseases and Transplantation ◽

10.4103/1319-2442.185238 ◽

2016 ◽

Vol 27 (4) ◽

pp. 752 ◽

Cited By ~ 5

Author(s):

Mahdia Buargub ◽

ZohraOmar Elmokhtar

Keyword(s):

Acute Kidney Injury ◽

Acute Coronary Syndrome ◽

Retrospective Study ◽

Coronary Care Unit ◽

Kidney Injury ◽

Coronary Syndrome ◽

Incidence And Mortality ◽

Coronary Care

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Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0032328 ◽

2012 ◽

Vol 7 (2) ◽

pp. e32328 ◽

Cited By ~ 26

Author(s):

Tien-Hsing Chen ◽

Chih-Hsiang Chang ◽

Chan-Yu Lin ◽

Chang-Chyi Jenq ◽

Ming-Yang Chang ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Coronary Care Unit ◽

Kidney Injury ◽

Coronary Care

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Outcomes of adults with congenital heart disease that experience acute kidney injury in the intensive care unit

Cardiology in the Young ◽

10.1017/s1047951120003923 ◽

2020 ◽

pp. 1-5

Author(s):

Dana Y. Fuhrman ◽

Lan Nguyen ◽

Emily L. Joyce ◽

Priyanka Priyanka ◽

John A. Kellum

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Congenital Heart Disease ◽

Young Adults ◽

Intensive Care ◽

Kidney Disease ◽

Renal Dysfunction ◽

Congenital Heart ◽

Kidney Injury ◽

Acute Kidney Disease

Abstract Background: Young adults with congenital heart disease (CHD) are increasing in number with an increased risk for acute kidney injury. Little is known concerning the impact of non-recovery of kidney function for these patients. Therefore, we sought to explore the rates of acute kidney disease, persistent renal dysfunction, and their associations with adverse outcomes in young adults with CHD. Methods: This is a single-centre retrospective study including all patients at the ages of 18–40 with CHD who were admitted to an intensive care unit between 2010 and 2014. Patients with a creatinine ≥ 1.5 times the baseline at the time of hospital discharge were deemed to have persistent renal dysfunction, while acute kidney disease was defined as a creatinine ≥ 1.5 times the baseline 7–28 days after a diagnosis of acute kidney injury. Outcomes of death at 5 years and length of hospital stay were examined using multivariable logistic regression and negative binomial regression, respectively. Results: Of the (89/195) 45.6% of patients with acute kidney injury, 33.7% had persistent renal dysfunction and 23.6% met the criteria for acute kidney disease. Persistent renal dysfunction [odds ratio (OR), 3.27; 95% confidence interval (CI): 1.15–9.29] and acute kidney disease (OR: 11.79; 95% CI: 3.75–39.09) were independently associated with mortality at 5 years. Persistent renal dysfunction was associated with a longer duration of hospital stay (Incidence Rate Ratio: 1.96; 95% CI: 1.53–2.51). Conclusions: In young adults with CHD, acute kidney injury was common and persistent renal dysfunction, as well as acute kidney disease, were associated with increased mortality and length of hospitalisation.

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Chronic progression of cardiac surgery associated acute kidney injury: Intermediary role of acute kidney disease

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2019.10.101 ◽

2019 ◽

Cited By ~ 12

Author(s):

Jin Sun Cho ◽

Jae-Kwang Shim ◽

Sak Lee ◽

Jong-Wook Song ◽

Nakcheol Choi ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Kidney Disease ◽

Kidney Injury ◽

Acute Kidney Disease ◽

Intermediary Role

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Acute kidney disease in hospitalized acute kidney injury patients

PeerJ ◽

10.7717/peerj.11400 ◽

2021 ◽

Vol 9 ◽

pp. e11400

Author(s):

Ping Yan ◽

Xiang-Jie Duan ◽

Yu Liu ◽

Xi Wu ◽

Ning-Ya Zhang ◽

...

Keyword(s):

Acute Kidney Injury ◽

Kidney Disease ◽

Critically Ill ◽

Kidney Injury ◽

Adverse Outcomes ◽

Additional Information ◽

Acute Kidney Disease ◽

Tertiary Hospitals ◽

One Year ◽

Stage 1

Background Acute kidney injury (AKI) and chronic kidney disease (CKD) have become worldwide public health problems, but little information is known about the epidemiology of acute kidney disease (AKD)—a state in between AKI and CKD. We aimed to explore the incidence and outcomes of hospitalized patients with AKD after AKI, and investigate the prognostic value of AKD in predicting 30-day and one-year adverse outcomes. Methods A total of 2,556 hospitalized AKI patients were identified from three tertiary hospitals in China in 2015 and followed up for one year.AKD and AKD stage were defined according to the consensus report of the Acute Disease Quality Initiative 16 workgroup. Multivariable regression analyses adjusted for confounding variables were used to examine the association of AKD with adverse outcomes. Results AKD occurred in 45.4% (1161/2556) of all AKI patients, 14.5% (141/971) of AKI stage 1 patients, 44.6% (308/691) of AKI stage 2 patients and 79.6% (712/894) of AKI stage 3 patients. AKD stage 1 conferred a greater risk of Major Adverse Kidney Events within 30 days (MAKE30) (odds ratio [OR], 2.36; 95% confidence interval 95% CI [1.66–3.36]) than AKD stage 0 but the association only maintained in AKI stage 3 when patients were stratified by AKI stage. However, compared with AKD stage 0, AKD stage 2–3 was associated with higher risks of both MAKE30 and one-year chronic dialysis and mortality independent of the effects of AKI stage with OR being 31.35 (95% CI [23.42–41.98]) and 2.68 (95% CI [2.07–3.48]) respectively. The association between AKD stage and adverse outcomes in 30 days and one year was not significantly changed in critically ill and non-critically ill AKI patients. The results indicated that AKD is common among hospitalized AKI patients. AKD stage 2–3 provides additional information in predicting 30-day and one-year adverse outcomes over AKI stage. Enhanced follow-up of renal function of these patients may be warranted.

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