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Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research
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Acute kidney injury as a prognostic determinant in cardiogenic shock: a cohort study

Priyanka Boettger1, Henriette Preusse-Sondermann2, Jamschid Sedighi3

  • 1Department of Internal Medicine I, Cardiology, Critical Care Medicine, Justus-Liebig University, Giessen, Germany. priyanka.boettger@uni-giessen.de.

Clinical and Experimental Nephrology
|November 12, 2025
PubMed

Insights

Acute kidney injury (AKI) is common in patients with cardiogenic shock (CS) after myocardial infarction, significantly worsening outcomes. Early identification of high-risk individuals is crucial for implementing timely renoprotective strategies.

Area of Science:

  • Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • Cardiogenic shock (CS) following myocardial infarction is associated with high mortality rates.
  • Acute kidney injury (AKI) is a frequent complication of CS, further deteriorating patient prognosis.
  • The prognostic significance of AKI and the need for renal replacement therapy (RRT) in CS patients require further investigation.

Purpose of the Study:

  • To investigate the prognostic relevance of AKI in patients with infarct-related CS.
  • To identify predictors of AKI and RRT in this patient population.
  • To evaluate the impact of AKI and RRT on in-hospital outcomes.

Main Methods:

  • Retrospective analysis of 369 patients with infarct-related CS admitted to a tertiary care center.
  • AKI diagnosis based on KDIGO criteria; data included clinical, laboratory, and hemodynamic parameters.
  • Multivariable logistic regression and AUC analysis were used to identify predictors and assess discriminatory power.

Main Results:

  • AKI occurred in 42.8% of patients, often within 48 hours and frequently classified as stage 3.
  • AKI patients were older, had more pre-existing chronic kidney disease (CKD), and required longer mechanical ventilation.
  • Predictors of AKI included age and norepinephrine dose; predictors of RRT included admission creatinine and absence of CPR. Overall mortality was 57.7%.

Conclusions:

  • AKI is a prevalent complication in infarct-related CS, associated with adverse outcomes.
  • Early identification of patients at high risk for AKI is essential.
  • Timely implementation of renoprotective strategies may improve outcomes in CS patients with AKI.
Abstract

Keywords:
Acute kidney injuryCardiogenic shockMortalityRenal replacement therapyRisk stratificationVasopressors

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