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Systolic and diastolic dysfunction affects kidney outcomes in hospitalized patients

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Authors
Choi, Jae Shin; Baek, Seon Ha; Chin, Ho Jun; Na, Ki Young; Chae, Dong-Wan; Kim, Yon Su; Kim, Sejoong; Han, Seung Seok
Issue Date
2018-10-23
Publisher
BioMed Central
Citation
BMC Nephrology, 19(1):292
Keywords
Acute kidney injuryEchocardiographyEnd-stage renal diseaseDiastolic dysfunctionSystolic dysfunction
Abstract
Backgrounds
Knowledge on cross-talk between the heart and kidney has been established by basic and clinical research. Nevertheless, the effects of systolic and diastolic heart dysfunctions on the development of acute kidney injury (AKI) and end-stage renal disease (ESRD) remain unresolved in hospitalized patients.

Methods
A total of 1327 hospitalized patients who had baseline transthoracic echocardiography performed were retrospectively analyzed. Patients were categorized by the quartiles of ejection fraction (EF) and the ratio of the early transmitral blood flow velocity to early diastolic velocity of the mitral annulus (E/e’). The odds ratios (ORs) for AKI and the hazard ratios (HRs) for ESRD were calculated after adjustment of multiple covariates.

Results
During hospital admission, AKI occurred in 210 (15.8%) patients. The lowest quartile of EF was associated with a risk of AKI (OR, 1.60 [1.07–2.41]) and the highest quartile of E/e’ was associated with a risk of AKI (OR, 1.90 [1.26–2.41]). When two echocardiographic parameters were combined, patients with a low EF (first to second quartiles) and high E/e’ (fourth quartile) showed the highest OR for AKI (OR, 2.27 [1.49–3.45]) compared with the counterpart patients. When the risk of ESRD was evaluated, E/e’, but not EF, was a significant parameter of high risk (fourth vs. first quartiles: HR, 4.13 [1.17–14.64]).

Conclusions
Baseline systolic and diastolic dysfunction is related to subsequent risks of AKI and ESRD in hospitalized patients. Monitoring of these parameters may be a useful strategy to predict the risk of these adverse events in the kidney.
ISSN
1471-2369
Language
English
URI
http://hdl.handle.net/10371/146856
DOI
https://doi.org/10.1186/s12882-018-1103-2
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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