Worsening Renal Function Is Common and Is Associated With Higher Mortality Rates in Cardiogenic Shock: A Cardiogenic...

Area of Science:

• Cardiology
• Nephrology
• Critical Care Medicine

Background:

• Outcomes associated with worsening renal function (WRF) in cardiogenic shock (CS) are not well understood.
• Understanding WRF in different CS etiologies is critical for patient management.

Purpose of the Study:

• To determine the incidence of WRF in heart failure-CS (HF-CS) and acute myocardial infarction-CS (AMI-CS).
• To examine the association between WRF and in-hospital mortality (IHM).
• To identify predictors of WRF in HF-CS versus AMI-CS.

Main Methods:

• Analysis of patients from the Cardiogenic Shock Working Group (CSWG) registry (2021-2024).
• WRF defined by creatinine increase, eGFR decrease, or renal replacement therapy (RRT) initiation within 72 hours.
• Exclusion of patients with baseline end-stage renal disease.

Main Results:

• 35% of CS patients developed WRF (32% HF-CS, 41% AMI-CS).
• WRF was associated with higher IHM (41% vs 21%).
• Independent predictors of WRF included right atrial pressure, lactate levels, and transfer status.

Conclusions:

• WRF is frequent and detrimental in both HF-CS and AMI-CS.
• WRF is a significant prognostic factor and a potential therapeutic target in CS.