Patients who have an acute kidney injury during hospitalization experienced a 44 percent higher relative risk of heart failure within one year of discharge, compared to those without acute kidney injury, reported new Kaiser Permanente research published today in the Clinical Journal of the American Society of Nephrology.
Acute kidney injury is a sudden decline in the ability of the kidneys to perform their normal function of filtering waste products from blood. People who are hospitalized for a wide variety of conditions, from major surgery to severe infection, are at risk for acute kidney injury, which can increase a patient's long-term risk of death even after they are successfully treated and sent home. "While Kaiser Permanente has had success in lowering rates of acute kidney injury in hospitalized patients, rates are rising nationwide, and even minor injury is linked to a higher risk of death," said Alan S. Go, MD, director of the Comprehensive Clinical Research Unit within the Kaiser Permanente Northern California Division of Research and lead author of the new study.
Earlier research by Dr. Go and colleagues linked hospitalized acute kidney injury to elevated risk of high blood pressure. In this new study, which adds to that body of work, the research team examined electronic health records of patients who were admitted to one of Kaiser Permanente's 21 hospitals in Northern California at some point between 2006 and 2013. They investigated whether the risk of various cardiovascular events within one year of leaving the hospital differed between patients who experienced acute kidney injury while hospitalized and those who did not. Out of 146,931 hospitalized patients included in the analysis, 31,245 experienced acute kidney injury. To help ensure an accurate comparison, patients with acute kidney injury were statistically matched to patients without acute kidney injury, according to similar demographics, length of hospital stay, medications they took, how acutely ill they were and other characteristics.
Meanwhile, Dr. Go and others are examining the mechanisms underlying the increased risk. "Kidney damage affects a number of biological pathways, including inflammation and mineral metabolism," Dr. Go said. "If we could understand how these changes increase risk of heart failure, we may be able to develop new strategies for prevention."