In-hospital acute kidney injury and atrial fibrillation: incidence, risk factors, and outcome

Abstract

Background: The incidence and the risk factors of in-hospitalized acute kidney injury (AKI) in patients hospitalized for atrial fibrillation (AF) were unclear. Methods: The Improving Care for Cardiovascular Disease in China-AF (CCC-AF) project is an ongoing registry and quality improvement project, with 240 hospitals recruited across China. We selected 4527 patients hospitalized for AF registered in the CCC-AF from January 2015 to January 2019. Patients were divided into the AKI and non-AKI groups according to the changes in serum creatinine levels during hospitalization. Results: Among the 4527 patients, the incidence of AKI was 8.0% (361/4527). Multivariate logistic analysis results indicated that the incidence of in-hospital AKI in patients with AF on admission was 2.6 times higher than that in patients with sinus rhythm (OR 2.60, 95% CI 1.77-3.81). Age (per 10-year increase, OR 1.22, 95% CI 1.07-1.38), atrial flutter/atrial tachycardia on admission (OR 2.16, 95% CI 1.12-4.15), diuretics therapy before admission (OR 1.48, 95% CI 1.07-2.04) and baseline hemoglobin (per 20 g/L decrease, OR 1.21, 95% CI 1.10-1.32) were independent risk factors for in-hospital AKI. b blockers therapy given before admission (OR 0.67, 95% CI 0.51-0.87) and non-warfarin therapy during hospitalization (OR 0.71, 95% CI 0.53-0.96) were associated with a decreased risk of in-hospital AKI. After adjustment for confounders, in-hospital AKI was associated with a 34% increase in risk of major adverse cardiovascular (OR 1.34, 95% CI 1.02-1.90, p ¼ 0.023). Conclusions: Clinicians should pay attention to the monitoring and prevention of in-hospital AKI to improve the prognosis of patients with AF.

Association of Postoperative Serum Lactate Levels with Acute Kidney Injury in Mexican Patients Undergoing Cardio‐Surgery

“…However, after adjustment only atrial fibrillation was independently associated with the development AKI in patients undergoing CS (OR: 3.11, 95% CI:1.08-9.40, p=0.037). In concordance with this finding, Wang et al reported that the risk of inhospital AKI increased significantly in patients hospitalized for atrial fibrillation [19]. Furthermore, the presence of risk factors for atrial fibrillation often coexists and may predispose to the development of kidney disease and vice versa.…”

Association of Postoperative Serum Lactate Levels with Acute Kidney Injury in Mexican Patients Undergoing Cardiac Surgery

“…However, after adjustment, only atrial fibrillation was independently associated with the development AKI in patients undergoing CS (OR: 3.11, 95% CI: 1.08-9.40, p = 0.037). In concordance with this finding, Wang et al reported that the risk of in-hospital AKI increased significantly in patients hospitalized due to atrial fibrillation [19]. Furthermore, the presence of risk factors for atrial fibrillation often coexists with and may predispose to the development of kidney disease, and vice versa.…”

Construction of a Glycaemia-Based Signature for Predicting Acute Kidney Injury in Ischaemic Stroke Patients after Endovascular Treatment

“…We showed similar prediction accuracy for these parameters in the ROC curve analysis. Wang et al recruited 4527 patients hospitalized for atrial fibrillation and found that the incidence of in-hospital AKI in patients with atrial fibrillation was 2.6 times higher than that in patients with sinus rhythm [38]. Atrial fibrillation is considered to be related to adverse renal outcomes and causes AKI by several mechanisms such as hemodynamic perturbations and renal ischaemia from an embolic event [39,40].…”