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Published on: February 16, 2011
Risk factors for acute kidney injury in patients with acute myocardial infarction
Cong Wang1, Yuan-Yuan Pei2, Yun-Hui Ma2
1Emergency Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
Insights
Acute kidney injury (AKI) affects 26% of patients with acute myocardial infarction (AMI), significantly increasing mortality. Identifying risk factors like age and hypertension is crucial for preventative care.
Area of Science:
- Cardiology
- Nephrology
- Clinical Medicine
Background:
- Acute kidney injury (AKI) is a critical complication of acute myocardial infarction (AMI).
- AKI in AMI patients has high mortality and poor prognosis.
- Understanding AKI's incidence and risk factors in China is vital for early intervention.
Purpose of the Study:
- To determine the incidence, risk factors, and outcomes of AKI in Chinese AMI patients.
- To identify independent risk factors for AKI in AMI.
- To aid in identifying high-risk patients for preventative strategies.
Main Methods:
- Retrospective review of 1124 hospitalized AMI patients (Oct 2013-Sep 2015).
- AKI diagnosis based on 2012 Kidney Disease Improving Global Outcomes criteria.
- Univariate and multiple logistic regression analyses to identify risk factors.
Main Results:
- AKI incidence was 26.0% among AMI patients.
- AKI group mortality was 20.5% vs. 0.6% in the non-AKI group (P < 0.001).
- Independent risk factors included older age, hypertension, CKD, Killip class ≥3, extensive anterior MI, furosemide use, and ACEI/ARB non-use.
Conclusions:
- AKI complicates 26% of AMI cases, strongly correlating with in-hospital mortality.
- Identified risk factors enable better identification of high-risk AMI patients.
- Findings support targeted clinical decisions for AKI prevention in AMI.
Background:
Acute kidney injury (AKI) is a serious and fatal complication of acute myocardial infarction (AMI). It has high short- and long-term mortality rates and a poor prognosis but is potentially preventable. However, the current incidence, risk factors, and outcomes of AKI in the Chinese population are not well understood and would serve the first step to identify high-risk patients who could receive preventative care.
Methods:
The medical data of 1124 hospitalized patients diagnosed with AMI from October 2013 to September 2015 were reviewed. AKI was defined according to the 2012 Kidney Disease Improving Global Outcomes criteria. All the patients were divided into either the AKI group or the non-AKI group. A univariate comparison analysis was performed to identify possible risk factors associated with AKI. A multiple logistic regression analysis was used to identify the independent risk factors for AKI in patients with AMI.
Results:
Overall, the incidence of AKI was 26.0%. The mortality rate of the AKI group was 20.5%, and the mortality rate of the non-AKI group was 0.6% (P < 0.001). Logistic regression analysis showed that the independent risk factors for AKI in patients with AMI included: age (>60 years old) (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.05, P = 0.000), hypertension (OR 2.51, 95% CI 1.62-3.87, P = 0.000), chronic kidney disease (OR 3.52, 95% CI 2.01-6.16, P = 0.000), Killip class ≥3 (OR 5.22, 95% CI 3.07-8.87, P = 0.000), extensive anterior myocardial infarction (OR 3.02, 95% CI 1.85-4.93, P = 0.000), use of furosemide (OR 1.02, 95% CI 1.02-1.03, P = 0.000), non-use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (OR 1.58, 95% CI 1.04-2.40, P = 0.032). These factors provided an accurate tool to identify patients at high risk of developing AKI.
Conclusions:
Approximately 26.0% of patients undergoing AMI developed AKI, and the development of AKI was strongly correlated with in-hospital mortality. The risk factors for AKI in patients with AMI were determined to help identify high-risk patients and make appropriate clinical decisions.
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