Acute kidney injury and renal function changes in cardiogenic shock

Area of Science:

• Nephrology
• Cardiology
• Critical Care Medicine

Background:

• Cardiogenic shock (CS) is a critical condition with high mortality.
• Acute kidney injury (AKI) is a common complication in CS patients.
• The prognostic value of AKI and estimated glomerular filtration rate (eGFR) in CS requires further elucidation.

Purpose of the Study:

• To investigate the prognostic significance of AKI and eGFR in patients experiencing CS.
• To identify predictors of AKI development in CS.
• To assess the utility of serial eGFR measurements in predicting outcomes.

Main Methods:

• Retrospective analysis of consecutive CS patients.
• Evaluation of AKI development within 48 hours of admission and its association with in-hospital mortality.
• Assessment of eGFR at baseline, 24 hours, and 48 hours for mortality prediction.
• Multivariable logistic regression to identify AKI predictors.

Main Results:

• AKI was independently associated with increased in-hospital mortality in CS patients (aOR 3.38).
• Mortality risk escalated with increasing AKI severity.
• 48-hour eGFR demonstrated superior accuracy in predicting mortality (AUC 0.789) compared to baseline (AUC 0.686) and 24-hour (AUC 0.754) eGFR.
• Chronic kidney disease (CKD), central venous pressure (CVP), and mean arterial pressure (MAP) were identified as AKI predictors.

Conclusions:

• AKI within 48 hours is an independent predictor of mortality in CS.
• The risk of mortality increases progressively with AKI severity.
• Serial eGFR assessment at 48 hours offers enhanced prognostic accuracy for mortality in CS patients.