Cardiovascular Consequences of Acute Kidney Injury

Burtscher, Johannes; Millet, Grégoire P.; Burtscher, Martin

doi:10.1056/nejmc2023901

Cited by 6 publications

(2 citation statements)

References 79 publications

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“…This may suggest that clinicians would benefit from the reports and observations from ultra-endurance athletes or sport scientists involved in this field. For example, it is possible to investigate regulatory mechanisms or organs interplay as the relationship between acute kidney injury and some adverse cardiac dysfunctions ( 66 ). Another example comes from professional cycling: arterial endofibrosis is a common pathology in cyclists ( 67 ) and it led to clinical improvement in its diagnosis and treatment ( 68 ).…”

Section: Monitoring Of Fatigue and Adaptationsmentioning

confidence: 99%

Look to the stars—Is there anything that public health and rehabilitation can learn from elite sports?

Millet

Chamari

2023

Front. Sports Act. Living

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Section: Monitoring Of Fatigue and Adaptationsmentioning

confidence: 99%

Look to the stars—Is there anything that public health and rehabilitation can learn from elite sports?

Millet

Chamari

2023

Front. Sports Act. Living

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“…Third, AKI causes changes in the dihydropyridine receptors on L-type calcium channels, leading to distortions in intracellular calcium homeostasis. In turn, alterations in the proteins that transport calcium may lead to cardiac dysfunction in the remodeling heart (Luo and Anderson, 2013;Feridooni et al, 2015;Burtscher et al, 2020). Fourth, deleterious upregulation of the reninangiotensin-aldosterone system resulting in fluid retention and peripheral arterial vasoconstriction, thereby increasing the preload and afterload of the left ventricle, which is one of the important mechanisms leading to ventricular remodeling (Murphy et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Increase Risk of Left Ventricular Remodeling: A Cohort of 1,573 Patients

Shi

Huang

et al. 2021

Front. Physiol.

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Background: Acute kidney injury (AKI) is a common complication after coronary angiography (CAG) and associated with heart failure (HF). Left ventricular (LV) remodeling is a vital process in the progression of HF. However, few studies investigate the relationship between AKI and LV remodeling.Methods: We included consecutive patients undergoing CAG from January 2007 to December 2018 at Guangdong Provincial People’s Hospital (NCT04407936). AKI was defined as an absolute increase in serum creatinine (Scr) of ≥ 0.3mg/dl or a ≥ 50% increase in Scr from baseline within the first 48–72 h after the procedure. LV remodeling was defined as: (1) an absolute decrease in left ventricular ejection fraction (LVEF) of ≥ 10% compared to baseline, or (2) a follow-up LVEF < 40%. Univariate and multivariate logistical regressions were used to assess the association between AKI and LV remodeling.Results: Of the 1,573 patients (62.2 ± 9.7 years, female 36.7%) included in the study, 231 (14.7%) had AKI. The incidence of LV remodeling was higher in patients with AKI than in those without AKI (24.7% vs. 14.5%). After adjusting for confounding, multivariate logistic regression showed that AKI was associated with a significantly higher risk of LV remodeling [adjusted odds ratio (aOR) 1.87; 95% CI, 1.30–2.66; p < 0.001]. In addition, LV remodeling patients had higher all-cause mortality compared to non-LV remodeling patients (9.7% vs. 19.1%).Conclusion: Our data suggested that AKI is present in up to 15% of patients after CAG and that nearly a quarter of AKI patients suffered LV remodeling and AKI patients have a two-fold risk of developing LV remodeling than non-AKI patients. Our findings suggest that more active measures be taken not only to prevent AKI patient developing into LV remodeling, but to prevent patients undergoing CAG from developing AKI.

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Could Repeated Cardio-Renal Injury Trigger Late Cardiovascular Sequelae in Extreme Endurance Athletes?

et al. 2022

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Regular exercise confers multifaceted and well-established health benefits. Yet, transient and asymptomatic increases in markers of cardio-renal injury are commonly observed in ultra-endurance athletes during and after competition. This has raised concerns that chronic recurring insults could cause long-term cardiac and/or renal damage. Indeed, extreme endurance exercise (EEE) over decades has sometimes been linked with untoward cardiac effects, but a causal relation with acute injury markers has not yet been established. Here, we summarize the current knowledge on markers of cardiac and/or renal injury in EEE athletes, outline the possible interplay between cardiac and kidney damage, and explore the roles of various factors in the development of potential exercise-related cardiac damage, including underlying diseases, medication, sex, training, competition, regeneration, mitochondrial dysfunction, oxidative stress, and inflammation. In conclusion, despite the undisputed health benefits of regular exercise, we speculate, based on the intimate link between heart and kidney diseases, that in rare cases excessive endurance sport may induce adverse cardio-renal interactions that under specific, hitherto undefined conditions could result in persistent cardiac damage. We highlight future research priorities and provide decision support for athletes and clinical consultants who are seeking safe strategies for participation in EEE training and competition.

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Cardiovascular Consequences of Acute Kidney Injury

Cited by 6 publications

References 79 publications

Look to the stars—Is there anything that public health and rehabilitation can learn from elite sports?

Look to the stars—Is there anything that public health and rehabilitation can learn from elite sports?

Acute Kidney Injury Increase Risk of Left Ventricular Remodeling: A Cohort of 1,573 Patients

Could Repeated Cardio-Renal Injury Trigger Late Cardiovascular Sequelae in Extreme Endurance Athletes?

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