Diabetes, Heart, and Cardiovascular Diseases News Chronicle.
Article 305   Published on February 13, 2018

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Acute Kidney Injury (AKI) Is An Independent Risk Factor To Heart Failure


An earlier study shows that an acute kidney injury (AKI) can progress into a chronic kidney disease (CKD) and the consequence of long-term acute kidney injury (known earlier as an acute renal failure) is poor.

An acute kidney injury (AKI) increases the risk of heart failure and cardiovascular disease.

A study on the veterans of the United States shows a marked association between an acute kidney injury (AKI) and heart failure. There is a three-fold increase in the risk of heart failure in people with an acute kidney injury (AKI) when compared to people without an acute kidney injury (AKI).

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The researchers have conducted a study between 2002 and 2013 on 300,868 veterans without a history of heart failure. The average age of the participants was 62 years and they used the Veterans Affairs hospitals for the purpose of this study. Researchers matched the patients with an acute kidney injury (AKI) and without an acute kidney injury (AKI) with variables such as age, year of admission, medications being used and pre-existing conditions.

The study shows people with an acute kidney injury (AKI) were more likely to be with the following factors.

  • An older person.
  • People from African Americans.
  • Suffering from high blood pressure (or hypertension).
  • A patient of type 2 diabetes (high blood sugar levels. T2D).
  • Using diuretics drugs.
  • Having a history of the sepsis infection.

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The study shows 23 percent of the enhanced risk of heart failure within two years in individuals with an acute kidney injury (AKI) when compared to individuals without an acute kidney injury (AKI). The following table shows the heart failure events among veterans in a two-year follow-up study.

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With an acute kidney injury Without an acute kidney injury Overall
30.8* 24.9* 27.8*
* Heart failure incidence per 1,000 person-years.

Those people who developed heart failure events after an acute kidney injury (AKI) are more likely to be with the following factors.

  • White race.
  • Elderly people.
  • High blood pressure (hypertension. BP)
  • High blood sugar levels (type 2 diabetes. T2D).
  • Excess protein in the urine (proteinuria).

Researchers also found 38 percent of the enhanced risk of heart failure in individuals without the risk factors to heart diseases such as high blood pressure, type 2 diabetes (T2D) and vascular diseases.

The patients with fewer health complications are at a higher risk of cardiovascular diseases following an acute kidney injury (AKI) compared with individuals with ongoing medical issues related to cardiovascular diseases. This indicates that an acute kidney injury (AKI) is an independent risk factor for heart failure. But the study could not find a cause and effect relationship between cardiovascular diseases or heart failure and an acute kidney injury (AKI).

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The limitations of the study are

  • Only five percent of the study participants were women.
  • An earlier study shows a higher rate of heart failure event in veterans compared to the general population.

Even though the current study was in line with the earlier studies, investigators say a further investigation is required to substantiate the study and to find out the mechanism behind the relationship. They also say that those patients who are recovering from an acute kidney injury (AKI) should pay more attention to the health factors which are contributing to cardiovascular diseases.

The lead investigator of the study was Dr. Nisha Bansal, M.D., M.A.S., an Associate Professor of Medicine, Division of Nephrology, Department of Medicine, University of Washington, Seattle, the United States. The study was published on November 20, 2017, in the American Journal of Kidney Diseases. Title of the article was "Acute Kidney Injury and Risk of Incident Heart Failure Among US Veterans."
DOI: dx.doi.org/10.1053/j.ajkd.2017.08.027

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Diuretics: These are also known as "fluid pills" or "water pills". These drugs can enhance the urine output from the kidneys to remove the fluid and salt from the body.

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