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Updated: Jun 26, 2025
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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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Heart failure subtype after acute kidney injury
Bethany C Birkelo1, Evan Brittain2, Andrew Guide3
1Division of Nephrology and Hypertension, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA. bbirkelo@umn.edu.
BMC Nephrology
|May 17, 2024
Summary
Acute kidney injury (AKI) is linked to heart failure (HF). Mild AKI (Stage 1) was significantly associated with heart failure with preserved ejection fraction (HFpEF), while severe AKI showed no significant link to HFpEF or HFrEF.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Acute kidney injury (AKI) increases the risk of developing heart failure (HF).
- Differentiating between HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) post-AKI may reveal underlying mechanisms and improve care.
- Understanding the specific HF type following AKI is crucial for targeted interventions.
Purpose of the Study:
- To investigate whether AKI is preferentially associated with HFpEF or HFrEF.
- To analyze the association between AKI severity and HF subtypes.
- To identify potential differences in HF development pathways after AKI.
Main Methods:
- Retrospective study of adult patients diagnosed with HF.
- Analysis of AKI events in the two years preceding HF diagnosis.
- Multivariable logistic regression models to assess AKI's impact on HFpEF vs. HFrEF, controlling for predictors.
Main Results:
- AKI overall showed a trend towards association with HFpEF (adjusted OR 0.80).
- Stage 1 AKI was significantly associated with higher odds of HFpEF (adjusted OR 0.62).
- Stages 2-3 AKI trended towards an association with HFrEF but did not reach statistical significance (adjusted OR 1.11).
Conclusions:
- AKI, particularly Stage 1, shows a preferential association with HFpEF.
- More severe AKI (Stages 2-3) did not significantly associate with either HFpEF or HFrEF.
- Distinct mechanisms may underlie HF development after mild versus severe AKI, necessitating tailored follow-up care.
- Close monitoring of volume status and cardiac function is recommended post-AKI, even after mild injury.
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