Acute kidney injury in patients with acute decompensated heart failure-cardiogenic shock: Prevalence, risk factors and outcome

Bottiroli, Maurizio; Calini, Angelo; Morici, Nuccia; Tavazzi, Guido; Galimberti, Luca; Facciorusso, Clorinda; Ammirati, Enrico; Russo, Claudio; Montoli, Alberto; Mondino, Michele

doi:10.1016/j.ijcard.2023.04.049

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…Acute kidney injury is a major determinant of mortality in patients with cardiogenic shock 6. A previous report described the renoprotective effect of mechanical support in patients with acute decompensated heart failure complicated by cardiogenic shock 7.…”

Section: Discussionmentioning

confidence: 99%

“…Acute kidney injury is a major determinant of mortality in patients with cardiogenic shock. 6 A previous report described the renoprotective effect of mechanical support in patients with acute decompensated heart failure complicated by cardiogenic shock. 7 Mechanical circulatory support could improve renal hypoperfusion and achieve haemodynamic stability, leading to improvement in renal function compared with standard inotropic therapy.…”

Section: Discussionmentioning

confidence: 99%

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Improvement of persistent anuria in severe myocardial infarction: the potential role of Impella 5.5 as a bridge to decision

Suzuki,

Sugiura

2023

BMJ Case Rep

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A man in his 40s with ST-segment elevation myocardial infarction complicating cardiogenic shock was transferred to our hospital. Emergent percutaneous coronary intervention for the left anterior descending and left circumflex arteries supported with Impella CP was performed. However, his cardiac function was severely impaired, and anuria developed, necessitating continuous renal replacement therapy (CRRT). After Impella CP was removed on day 6, the patient remained dependent on inotropes and CRRT. Following volume reduction to manage pulmonary congestion, symptoms of low perfusion appeared. Then, Impella 5.5 was inserted on day 38 as a bridge to decision. On day 52, the urine volume reached >2000 mL/day, and CRRT was discontinued. On day 56, the patient was transferred to a certified facility for left ventricular assist device implantation or heart transplantation. This case suggests the potential of Impella 5.5 as a bridge to decision in patients with organ failure caused by low cardiac output.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improvement of persistent anuria in severe myocardial infarction: the potential role of Impella 5.5 as a bridge to decision

Suzuki,

Sugiura

2023

BMJ Case Rep

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Nutrition Care Process on Obesity Patient with Acute Decompensated Heart Failure (ADHF) Wet and Warm, Atrial Fibrillation Moderate Ventricular Response, and Acute Kidney Injury: A Case Report

Oktaviani,

Farapti,

Mahmudiono

et al. 2024

MGK

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Background: Obesity is caused by an imbalance between excessive energy intake and insufficient physical activity over a prolonged period. Obesity can increase the risk of metabolic syndrome, including heart failure. Severe heart failure can further elevate the risk of complications such as atrial fibrillation and acute kidney injury. In order to mitigate the exacerbation of heart failure severity in obese patients, it is imperative to institute a cardiovascular diet therapy employing the principles of adequate energy provision, low-fat content, and restricted protein intake within the framework of a Nutrition Care Process (NCP). Objective: To investigate the management of standard nutritional care in obese patients with acute decompensated heart failure, atrial fibrillation, and acute kidney injury through the administration of a cardiovascular diet. Methods: A case study was conducted in February 2023 on a patient at the University of Airlangga Infectious Disease Hospital, Surabaya. Results: The results of the clinical evaluation demonstrated an improvement in the patient's physical condition, as evidenced by the absence of dyspnea and stable vital signs within the normal range at the end of the intervention. The patient's food intake increased progressively, although some macronutrient targets were not fully met (<75%). Conclusion: The patient's condition showed significant improvement, as indicated by positive changes in physical/clinical monitoring. Additionally, there was an increase in food intake, although the target macronutrient intake was not fully achieved.

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Urinary Output as a Predictor of Mortality in Cardiogenic Shock: An Explorative Retrospective Analysis

Markart,

Hermann,

Chiari

et al. 2024

JCM

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Background/Objectives: Cardiogenic shock (CS) remains a critical condition with high mortality rates despite advances in treatment. This study aimed to evaluate the prognostic significance of urinary output at various time intervals during CS and its effectiveness as a predictor of 30-day mortality, particularly in comparison to the Simplified Acute Physiology Score 3 (SAPS 3). Methods: We conducted a retrospective analysis of 96 patients diagnosed with CS, assessing urinary output at different intervals (0–6 h, 6–12 h, 12–24 h, and 0–24 h) as potential predictors of 30-day mortality. SAPS 3 was calculated for all patients, and its predictive value was compared to that of urinary output using both univariate and multivariate analyses. Additional analyses included ROC curve assessment and Kaplan–Meier survival analysis. Results: Urinary output at 6–12 h was significantly associated with 30-day mortality in univariate analysis. Area under the receiver operating characteristic curves (AUROCs) for urinary output at 0–6 h, 6–12 h, and 12–24 h was 0.61 (p = 0.07), 0.63 (p = 0.04), and 0.61 (p = 0.08), respectively. These AUROCs did not differ significantly between the three urinary output parameters. Regarding the cumulative urinary output of 0–24 h, the most pronounced impact was observed in patients producing less than 0.5 mL/kg/h. In multivariate analysis, when combined with SAPS 3, the predictive power of urinary output diminished. SAPS 3 alone demonstrated significant predictive value with an AUROC of 0.77 (p < 0.001). Conclusions: While early urinary output is a valuable predictor of 30-day mortality in patients with CS, its prognostic strength is limited when considered alongside comprehensive risk assessments like SAPS 3. These findings suggest that a multifaceted approach, incorporating both early and comprehensive indicators, is essential for accurately predicting outcomes in CS patients.

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Acute kidney injury in patients with acute decompensated heart failure-cardiogenic shock: Prevalence, risk factors and outcome

Cited by 3 publications

References 39 publications

Improvement of persistent anuria in severe myocardial infarction: the potential role of Impella 5.5 as a bridge to decision

Improvement of persistent anuria in severe myocardial infarction: the potential role of Impella 5.5 as a bridge to decision

Nutrition Care Process on Obesity Patient with Acute Decompensated Heart Failure (ADHF) Wet and Warm, Atrial Fibrillation Moderate Ventricular Response, and Acute Kidney Injury: A Case Report

Urinary Output as a Predictor of Mortality in Cardiogenic Shock: An Explorative Retrospective Analysis

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