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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Acute Kidney Disease After Acute Decompensated Heart Failure
Jia-Jin Chen1,2, Tao-Han Lee1,2,3, George Kuo1
1Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan city, Taiwan.
Kidney International Reports
|March 8, 2022
Summary
Acute kidney disease (AKD) affects 21.2% of patients with acute decompensated heart failure (ADHF). AKD significantly increases risks for death, major adverse kidney events, and heart failure hospitalization.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Acute kidney disease (AKD) is a kidney injury continuum occurring 7-90 days post-acute kidney injury (AKI).
- The incidence and prognosis of AKD following acute decompensated heart failure (ADHF) remain poorly understood.
Purpose of the Study:
- To investigate the incidence of AKD and AKI-to-AKD transitions in ADHF patients.
- To identify AKD risk factors and develop a predictive model for AKD.
- To assess the long-term prognosis of AKD in this population.
Main Methods:
- Analysis of 7519 ADHF patients from a multi-institutional database (2008-2018).
- Evaluation of composite outcomes: stage 3 AKD and all-cause death.
- Assessment of AKD's impact on major adverse kidney events (MAKEs), all-cause death, and heart failure hospitalization (HFH) over 5 years.
Main Results:
- The incidence of AKI and AKD post-ADHF was 9% and 21.2%, respectively.
- 39.4% of AKI patients and 19.4% of non-AKI patients developed AKD.
- Predictive models showed C-statistics of 0.726 for any-stage AKD and 0.807 for stage 3 AKD/death; AKD significantly increased risks for death, MAKEs, and HFH (P < 0.001).
Conclusions:
- AKD following ADHF is linked to adverse outcomes.
- The developed model aids in identifying patients at risk for AKD, including those without an initial AKI episode.
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