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AKI and long-term risk for cardiovascular events and mortality


Odutayo, A and Wong, CX and Farkouh, M and Altman, DG and Hopewell, S and Emdin, CA and Hunn, BH, AKI and long-term risk for cardiovascular events and mortality, Journal of the American Society of Nephrology, 28, (1) pp. 1-11. ISSN 1046-6673 (2016) [Refereed Article]

Copyright Statement

Copyright 2016 American Society of Nephrology

DOI: doi:10.1681/ASN.2016010105


AKI associates with increased long-term risk of mortality, but the prognostic significance of AKI in terms of long-term cardiovascular disease remains unconfirmed. We conducted a systematic review and meta-analysis to assess whether AKI associates with long-term cardiovascular disease. We included cohort studies that examined adults with and without AKI and reported a multivariable-adjusted relative risk (RR) for the association between AKI and cardiovascular mortality, major cardiovascular events, and disease-specific events: congestive heart failure, acute myocardial infarction, and stroke. Twenty-five studies involving 254,408 adults (55,150 with AKI) were included. AKI associated with an 86% and a 38% increased risk of cardiovascular mortality and major cardiovascular events, respectively ([RR 1.86; 95% confidence interval (95% CI), 1.72 to 2.01] and [RR 1.38; 95% CI, 1.23 to 1.55], respectively). For disease-specific events, AKI associated with a 58% increased risk of heart failure (RR 1.58; 95% CI, 1.46 to 1.72) and a 40% increased risk of acute myocardial infarction (RR 1.40; 95% CI, 1.23 to 1.59). The elevated risk of heart failure and acute myocardial infarction persisted in subgroup analyses on the basis of AKI severity and the proportion of adults with baseline ischemic heart disease. Finally, AKI was associated with a 15% increased risk of stroke (RR 1.15; 95% CI, 1.03 to 1.28). In conclusion, AKI associates with an elevated risk of cardiovascular mortality and major cardiovascular events, particularly heart failure and acute myocardial infarction.

Item Details

Item Type:Refereed Article
Keywords:acute kidney injury, acute renal failure, cardiovascular disease, stroke, congestive heart failure, ischemic heart disease
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Hunn, BH (Dr Ben Hunn)
ID Code:110414
Year Published:2016
Web of Science® Times Cited:187
Deposited By:Medicine
Deposited On:2016-07-26
Last Modified:2022-08-29

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