Long-term risk of coronary events after AKI
Journal
Journal of the American Society of Nephrology
Journal Volume
25
Journal Issue
3
Pages
595-605
Date Issued
2014
Author(s)
Wu C.-H.
Wang C.-Y.
Shiao C.-C.
Chang C.-H.
Tsai P.-R.
Chen L.
Ko W.-J.
Abstract
The incidence rate of AKI in hospitalized patients is increasing. However, relatively little attention has been paid to the association of AKI with long-term risk of adverse coronary events. Our study investigated hospitalized patients who recovered from de novo dialysis-requiring AKI between 1999 and 2008 using patient data collected from inpatient claims from Taiwan National Health Insurance. We used Cox regression with time-varying covariates to adjust for subsequent CKD and ESRD after discharge. Results were further validated by analysis of a prospectively constructed database. Among 17,106 acute dialysis patients who were discharged, 4869 patients recovered from dialysis-requiring AKI (AKI recovery group) and were matched with 4869 patients without AKI (non-AKI group). The incidence rates of coronary events were 19.8 and 10.3 per 1000 person-years in the AKI recovery and non-AKI groups, respectively. AKI recovery associated with higher risk of coronary events (hazard ratio [HR], 1.67; 95% confidence interval [95% CI], 1.36 to 2.04) and all-cause mortality (HR, 1.67; 95% CI, 1.57 to 1.79) independent of the effects of subsequent progression to CKD and ESRD. The risk levels of de novo coronary events after hospital discharge were similar in patients with diabetes alone and patients with AKI alone (P=0.23). Our results reveal that AKI with recovery associated with higher long-term risks of coronary events and death in this cohort, suggesting that AKI may identify patients with high risk of future coronary events. Enhanced postdischarge follow-up of renal function of patients who have recovered from temporary dialysis may be warranted. Copyright ? 2014 by the American Society of Nephrology.
SDGs
Other Subjects
acute kidney failure; adult; article; cardiovascular risk; chronic kidney disease; controlled study; coronary artery disease; diabetes mellitus; dialysis; disease course; end stage renal disease; female; hemodialysis patient; hospital discharge; hospital patient; human; incidence; major clinical study; male; middle aged; mortality; priority journal; risk assessment; Acute Kidney Injury; Adult; Aged; Aged, 80 and over; Case-Control Studies; Cohort Studies; Coronary Disease; Diabetes Complications; Female; Humans; Male; Middle Aged; Prospective Studies; Taiwan
Type
journal article