AKI and Long-Term Risk for Cardiovascular Events and Mortality

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

[学科分类] 泌尿医学