Heart Failure And Acute Kidney Injury

1338 Words Aug 21st, 2015 6 Pages
Our current study demonstrates that among hospitalized HF patients, 2179 (32%) had traditional AKI (rise in serum creatinine by >=0.3 mg/dl) and 789 (12%) of hospitalized HF patients developed reverse AKI (drop in serum creatinine by >=0.3 mg/dl). The change in serum creatinine of greater than or equal to 0.3mg/dl was associated with higher 30-day all-cause readmission and mortality. Interestingly, reverse AKI group was also associated with higher 30-day all-cause readmission and mortality. To our knowledge this is the first study that reports 30-day all cause readmission and mortality by serial changes in serum creatinine in hospitalized HF patients. There is a need for increased awareness regarding this particular subset of patients.
There is an interdependence between acute decompensated heart failure and acute kidney injury as one can lead to another and hence get into a vicious cycle. Heart failure is a state of neurohormonal imbalance. Pathophysiology of AKI in Heart failure patients is mediated by various pathways mainly, by reduced perfusion to kidneys leading to venous congestion, by reduced response to diuretic therapy secondary to post-diuretic sodium retention, and also secondary to the use of large doses of diuretics, nephrotoxic medications and use of iodinated IV contrasts for procedures like cardiac catheterization or CT scans7. As clinicians, we are well versed in identifying AKI and subsequently taking preventive measures to stop the progression of AKI…

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