Acute kidney injury in cardiogenic shock: definitions,
incidence, haemodynamic alterations, and mortality

J 2018

Acute kidney injury in cardiogenic shock: definitions, incidence, haemodynamic alterations, and mortality

TARVASMAKI, T., M. HAAPIO, A. MEBAZAA, A. SIONIS, J. SILVA-CARDOSO et. al.

Základní údaje

Originální název

Acute kidney injury in cardiogenic shock: definitions, incidence, haemodynamic alterations, and mortality

Autoři

TARVASMAKI, T., M. HAAPIO, A. MEBAZAA, A. SIONIS, J. SILVA-CARDOSO, H. TOLPPANEN, M.G. LINDHOLM, K. PULKKI, J. PARISSIS, V.P. HARJOLA a J. LASSUS

Vydání

European Journal of heart Failure, Hoboken, Wiley, 2018, 1388-9842

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 12.129

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1002/ejhf.958

UT WoS

000428392800029

Klíčová slova anglicky

Cardiogenic shock; Acute kidney injury; KDIGO; Urine output; Haemodynamics; Mortality

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 10. 9. 2019 14:01, Mgr. Tereza Miškechová

Anotace

V originále

Aims To investigate the incidence, haemodynamic alterations and 90-day mortality of acute kidney injury (AKI) in patients with cardiogenic shock. We assessed the utility of creatinine, urine output (UO) and cystatin C (CysC) definitions of AKI in prognostication. Methods and results Cardiogenic shock patients with serial plasma samples (n = 154) from the prospective multicenter CardShock study were included in the analysis. Acute kidney injury was defined and staged according to the KDIGO criteria by creatinine (AKI(crea)) and/or UO (AKI(UO)). CysC-based AKI (AKI(CysC)) was defined similarly to AKI(crea). Changes in haemodynamic parameters were assessed over time from baseline until 96 h. Mean age of the study population was 66 +/- 12 years and 74% were men. Median baseline creatinine was 1.12 [interquartile range (IQR) 0.87-1.54] mg/dL and CysC 1.19 (IQR 0.90-1.69) mg/L. The 90-day mortality was 38%. The incidences for AKI were: AKI(crea) 31%, AKI(UO) 50%, and AKI(Cysc) 33%. AKI(crea) [odds ratio (OR) 12.2, 95% confidence interval (CI) 4.1-36.0] and AKI(CysC) (OR 2.5, 95% CI 1.1-6.1), but not AKI(UO), were independent predictors of mortality. However, a stricter UO cut-off of < 0.3 mL/kg/h for 6 h was independently associated with 90-day mortality (OR 3.6, 95% CI 1.4-9.3). Development of AKI was associated with persistently elevated central venous pressure and decreased cardiac index and mean arterial pressure. Conclusions Acute kidney injury is frequent in patients with cardiogenic shock and especially AKI(crea) predicts poor outcome. The KDIGO UO criterion seems, however, rather liberal and a stricter AKI definition of UO <0.3 mL/kg/h for at least 6 h seems more useful for mortality risk prediction. Haemodynamic alterations reflecting venous congestion and hypoperfusion were associated with AKI.

Citovat

TARVASMAKI, T., M. HAAPIO, A. MEBAZAA, A. SIONIS, J. SILVA-CARDOSO, H. TOLPPANEN, M.G. LINDHOLM, K. PULKKI, J. PARISSIS, V.P. HARJOLA a J. LASSUS. Acute kidney injury in cardiogenic shock: definitions, incidence, haemodynamic alterations, and mortality. European Journal of heart Failure. Hoboken: Wiley, 2018, roč. 20, č. 3, s. 572-581. ISSN 1388-9842. Dostupné z: https://dx.doi.org/10.1002/ejhf.958.

@article{1435298,
   author = {Tarvasmaki, T. and Haapio, M. and Mebazaa, A. and Sionis, A. and SilvaandCardoso, J. and Tolppanen, H. and Lindholm, M.G. and Pulkki, K. and Parissis, J. and Harjola, V.P. and Lassus, J. and Špinar, Jindřich and Pařenica, Jiří and Štípal, Roman and Ludka, Ondřej and Ganovská, Eva and Kubena, Petr},
   article_location = {Hoboken},
   article_number = {3},
   doi = {http://dx.doi.org/10.1002/ejhf.958},
   keywords = {Cardiogenic shock; Acute kidney injury; KDIGO; Urine output; Haemodynamics; Mortality},
   language = {eng},
   issn = {1388-9842},
   journal = {European Journal of heart Failure},
   title = {Acute kidney injury in cardiogenic shock: definitions, incidence, haemodynamic alterations, and mortality},
   url = {http://dx.doi.org/10.1002/ejhf.958},
   volume = {20},
   year = {2018}
}

TY  - JOUR
ID  - 1435298
AU  - Tarvasmaki, T. - Haapio, M. - Mebazaa, A. - Sionis, A. - Silva-Cardoso, J. - Tolppanen, H. - Lindholm, M.G. - Pulkki, K. - Parissis, J. - Harjola, V.P. - Lassus, J. - Špinar, Jindřich - Pařenica, Jiří - Štípal, Roman - Ludka, Ondřej - Ganovská, Eva - Kubena, Petr
PY  - 2018
TI  - Acute kidney injury in cardiogenic shock: definitions, incidence, haemodynamic alterations, and mortality
JF  - European Journal of heart Failure
VL  - 20
IS  - 3
SP  - 572-581
EP  - 572-581
PB  - Wiley
SN  - 13889842
KW  - Cardiogenic shock
KW  - Acute kidney injury
KW  - KDIGO
KW  - Urine output
KW  - Haemodynamics
KW  - Mortality
UR  - http://dx.doi.org/10.1002/ejhf.958
L2  - http://dx.doi.org/10.1002/ejhf.958
N2  - Aims To investigate the incidence, haemodynamic alterations and 90-day mortality of acute kidney injury (AKI) in patients with cardiogenic shock. We assessed the utility of creatinine, urine output (UO) and cystatin C (CysC) definitions of AKI in prognostication. Methods and results Cardiogenic shock patients with serial plasma samples (n = 154) from the prospective multicenter CardShock study were included in the analysis. Acute kidney injury was defined and staged according to the KDIGO criteria by creatinine (AKI(crea)) and/or UO (AKI(UO)). CysC-based AKI (AKI(CysC)) was defined similarly to AKI(crea). Changes in haemodynamic parameters were assessed over time from baseline until 96 h. Mean age of the study population was 66 +/- 12 years and 74% were men. Median baseline creatinine was 1.12 [interquartile range (IQR) 0.87-1.54] mg/dL and CysC 1.19 (IQR 0.90-1.69) mg/L. The 90-day mortality was 38%. The incidences for AKI were: AKI(crea) 31%, AKI(UO) 50%, and AKI(Cysc) 33%. AKI(crea) [odds ratio (OR) 12.2, 95% confidence interval (CI) 4.1-36.0] and AKI(CysC) (OR 2.5, 95% CI 1.1-6.1), but not AKI(UO), were independent predictors of mortality. However, a stricter UO cut-off of < 0.3 mL/kg/h for 6 h was independently associated with 90-day mortality (OR 3.6, 95% CI 1.4-9.3). Development of AKI was associated with persistently elevated central venous pressure and decreased cardiac index and mean arterial pressure. Conclusions Acute kidney injury is frequent in patients with cardiogenic shock and especially AKI(crea) predicts poor outcome. The KDIGO UO criterion seems, however, rather liberal and a stricter AKI definition of UO <0.3 mL/kg/h for at least 6 h seems more useful for mortality risk prediction. Haemodynamic alterations reflecting venous congestion and hypoperfusion were associated with AKI.
ER  -

TARVASMAKI, T., M. HAAPIO, A. MEBAZAA, A. SIONIS, J. SILVA-CARDOSO, H. TOLPPANEN, M.G. LINDHOLM, K. PULKKI, J. PARISSIS, V.P. HARJOLA a J. LASSUS. Acute kidney injury in cardiogenic shock: definitions, incidence, haemodynamic alterations, and mortality. \textit{European Journal of heart Failure}. Hoboken: Wiley, 2018, roč.~20, č.~3, s.~572-581. ISSN~1388-9842. Dostupné z: https://dx.doi.org/10.1002/ejhf.958.

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