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Patients with acute kidney injury ‘at increased risk of heart failure’

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Patients with acute kidney injury face a significantly greater risk of heart failure during their first year after leaving hospital, according to US researchers.

A study, published in the Clinical Journal of the American Society of Nephrology, highlights the importance of monitoring for signs of heart failure after hospital discharge, said those behind it.

“Earlier detection of heart failure symptoms in these patients could potentially save lives”

Kathleen Liu

The researchers examined electronic health records of patients who were admitted to any one of US healthcare firm 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 and those who did not.

Out of 146,931 patients included in the analysis, 31,245 experienced acute kidney injury while in hospital.

Patients with acute kidney injury were matched to other patients, according to demographics, length of hospital stay, medications, how acutely ill they were and other characteristics.

Roughly one in 25 people who were admitted to hospital for any reason would experience heart failure within a year, said the US researchers.

Their analysis found patients with an acute kidney injury while in hospital experienced a 44% higher relative risk of heart failure within one year of discharge, compared to those without kidney injury.

Rates of other cardiovascular events linked to atherosclerosis did not differ significantly between the two groups, said the researchers.

“Our results highlight heart failure as a key risk for patients who experienced acute kidney injury in the hospital”

Alan Go

Lead study author Dr Alan Go, from the Kaiser Permanente Northern California Division of Research, noted that rates of acute kidney injury in hospital patients were rising nationally in the US.

“Overall, our results highlight heart failure as a key risk for patients who experienced acute kidney injury in the hospital,” he stated.

Senior author Dr Kathleen Liu, from the University of California, San Francisco, said the findings suggested that clinicians need to be more vigilant in looking for signs of heart failure in patients who experienced acute kidney injury during admission.

“Earlier detection of heart failure symptoms in these patients could potentially save lives,” she said.

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,” he said.

“If we could understand how these changes increase risk of heart failure, we may be able to develop new strategies for prevention,” he added.

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