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Predictors and Prognostic Impact of Early Acute Kidney Injury in Cardiogenic Shock: Results from a Monocentric,
Tobias Schupp1,2, Michael Behnes3,4, Jonas Rusnak3,4
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University, Heidelberg, Germany, tobias.schupp@umm.de.
Acute kidney injury (AKI) affects over half of patients with cardiogenic shock (CS) and significantly increases their 30-day mortality risk. AKI requiring continuous veno-venous hemodiafiltration (CVVHDF) presents the highest mortality risk in CS patients.
Area of Science:
- Cardiology
- Nephrology
- Critical Care Medicine
Background:
- Acute kidney injury (AKI) is a known risk factor for mortality in acute myocardial infarction patients.
- Limited data exists on the prognostic impact of early AKI in patients experiencing cardiogenic shock (CS).
Purpose of the Study:
- To investigate predictors of AKI in CS patients.
- To assess the prognostic impact of early AKI on 30-day all-cause mortality in CS patients.
Main Methods:
- Retrospective analysis of consecutive CS patients from 2019-2021.
- AKI defined by creatinine increase or need for continuous veno-venous hemodiafiltration (CVVHDF).
- Statistical analyses included Cox regression and Kaplan-Meier curves to evaluate mortality predictors and outcomes.
Main Results:
- 52% of CS patients developed early AKI.
- Elevated lactate levels were associated with AKI occurrence (OR=1.194, p=0.001).
- AKI independently increased 30-day mortality risk (HR=1.861, p=0.005), with CVVHDF requirement showing the highest risk (HR=2.211, p=0.003).
Conclusions:
- Early AKI is prevalent in over half of CS patients.
- AKI is an independent predictor of 30-day mortality in CS.
- Patients with AKI requiring CVVHDF face the highest mortality risk.
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