Acute kidney injury and risk of cardiovascular outcomes: A nationwide cohort study

作者：Philip Andreas Schytz, Paul Blanche, Anders Bonde Nissen, Christian Torp‐Pedersen, Gunnar Gislason, Karl Emil Nelveg-Kristensen, Kristine Hommel, Nicholas Carlson · 发表于：Nefrología (English Edition) · 年份：2022 · DOI：10.1016/j.nefroe.2022.06.003 · 被引用次数：9 · 研究领域：Acute Kidney Injury Research、Chronic Kidney Disease and Diabetes、Erythropoietin and Anemia Treatment

Acute kidney injury (AKI) has been associated with cardiovascular disease, but this is sparsely studied in non-selected populations and with little attention to the effect in age and renal function. Using nationwide administrative data, we investigated the hypothesis of increased one-year risk of cardiovascular event or death associated with AKI. In a cohort study, we identified all admissions in Denmark between 2008 and 2018. AKI was defined as ≥1.5 times increase from baseline to peak creatinine during admission, or dialysis. We excluded patients with age <50 years, estimated glomerular filtration rate (eGFR) <15 ml/min/1.73 m2, renal transplantation, index-admission due to cardiovascular disease or death during index-admission. The primary outcome was cardiovascular risk within one year from discharge, which was a composite of the secondary outcomes ischemic heart disease, heart failure or stroke. To estimate risks, we applied multiple logistic regression fitted by inverse probability of censoring weighting and stratified estimations by eGFR and age. We adjusted for proteinuria in the subcohort with measurements available. Among 565,056 hospital admissions, 39,569 (7.0%) cases of AKI were present. In total, 18,642 patients sustained a cardiovascular outcome. AKI was significantly associated with cardiovascular outcome with an adjusted OR [CI] of 1.33 [1.16–1.53], 1.43 [1.33–1.54], 1.23 [1.14–1.34], 1.38 [1.18–1.62] for eGFR ≥90, 60–89, 30–59 and 15–29 ml/min/1.73 m2, respe...