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Effect of kidney disease on acute coronary syndrome

Fernando B Rodrigues1, Rosana G Bruetto, Ulysses S Torres

  • 1Department of Internal Medicine, Division of Emergency, Hospital de Base, Sao Jose do Rio Preto Medical School (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil.

Clinical Journal of the American Society of Nephrology : CJASN
|June 26, 2010
PubMed

Insights

Chronic kidney disease (CKD) worsens outcomes for acute coronary syndrome (ACS) patients. Limited data exist on acute kidney injury (AKI) after ACS, highlighting the need for prospective studies and renal function monitoring.

Area of Science:

  • Nephrology
  • Cardiology
  • Critical Care Medicine

Background:

  • Chronic kidney disease (CKD) is a prevalent condition globally, significantly increasing adverse outcomes in patients with acute coronary syndrome (ACS).
  • CKD is consistently linked to poorer prognosis in myocardial infarction patients.
  • Data on acute kidney injury (AKI) following ACS is scarce, primarily from retrospective studies with significant exclusions.

Purpose of the Study:

  • To review existing data on the impact of CKD and AKI on clinical outcomes after ACS.
  • To highlight the lack of prospective studies evaluating AKI diagnostic criteria (AKIN, RIFLE) as risk factors for mortality post-ACS.
  • To emphasize the importance of early serum creatinine measurement and renal function monitoring in ACS patients.

Main Methods:

  • Literature review of studies investigating CKD and AKI in the context of ACS.
  • Analysis of available retrospective data on AKI and ACS outcomes.
  • Discussion of diagnostic criteria for AKI, including RIFLE and AKIN.

Main Results:

  • CKD is a well-established predictor of poor prognosis in ACS.
  • Evidence regarding AKI's impact on ACS outcomes is limited and derived from non-prospective studies.
  • No prospective studies have validated AKIN or RIFLE criteria for AKI risk stratification after ACS, nor compared these criteria directly.

Conclusions:

  • Early assessment of renal function via serum creatinine is crucial upon ACS admission.
  • Continuous renal function monitoring throughout hospitalization is essential for ACS patients.
  • Further prospective research is needed to clarify the role of AKI and its diagnostic criteria in ACS prognosis.

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