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

Acute kidney injury (AKI) is an independent risk factor to heart failure

Earlier studies show acute kidney injury AKI will progress into chronic kidney disease (CKD) and the long-term consequence of acute kidney injury AKI (earlier known as acute renal failure) is poor. A study done on the United States veterans shows a marked association between acute kidney injury (AKI) and heart failure. There is an enhanced threefold risk of heart failure in people with acute kidney injury (AKI) when compared to people without AKI.

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

The study results show people with acute kidney injury (AKI) were more likely to be with following factors.

  • Older person.
  • People of the African American race.
  • With high blood pressure or hypertension.
  • With high blood sugar levels or type 2 diabetes (T2D).
  • Using diuretics drugs.
  • Experienced sepsis infection.

The findings show 23 percent enhanced risk of heart failure within two years among individuals with acute kidney injury (AKI) when compared to individuals without acute kidney injury (AKI). The following table shows heart failure events among veterans during two-year follow-up studies.

With AKI group Without AKI group       Overall      
30.8* 24.9* 27.8*
* Heart failure incidence per 1,000 person-years.

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

  • White race.
  • Older individual.
  • High blood pressure (BP) or hypertension.
  • High blood sugar levels or type 2 diabetes (T2D).
  • Excess protein in their urine (proteinuria).

Researchers also found 38 percent enhanced risk of heart failure among individuals without heart diseases risk factors such as high blood pressure, type 2 diabetes (T2D), cardiac surgery or vascular diseases. Patients with fewer health complications may face cardiovascular problems following acute kidney injury (AKI) compared with individuals with ongoing medical issues related to cardiovascular diseases. This indicates acute kidney injury (AKI) is an independent risk factor for heart failure. But the study could not find the reason for the association between the development of cardiovascular diseases or heart failure and acute kidney injury (AKI).

Limitations of the study are

  • Only 5 percent of the study participants were women.
  • Earlier studies show a higher rate of heart failure events among veterans compared to general population.

Even though the current study findings were in line with the findings of similar studies, investigators say further investigations are required to substantiate the results and to find out the mechanism behind the relationship. They also say those patients who are recovering from acute kidney injury (AKI) should pay more attention to their health factors contributing to cardiovascular diseases.

Acute kidney injury (AKI) enhances the risk of heart failure and cardiovascular diseases among individuals.

Lead investigator of the study was Dr. Nisha Bansal, M.D., M.A.S., Associate Professor of Medicine, Nephrology, Kidney Research Institute, University of Washington, Seattle, the United States. The study findings were published 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 enhance urine output in the kidneys to remove fluid and salt from the body.



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