S-Space College of Medicine/School of Medicine (의과대학/대학원) Internal Medicine (내과학전공) Journal Papers (저널논문_내과학전공)
Systolic and diastolic dysfunction affects kidney outcomes in hospitalized patients
- 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
- BioMed Central
- BMC Nephrology, 19(1):292
- Acute kidney injury; Echocardiography; End-stage renal disease; Diastolic dysfunction; Systolic dysfunction
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.
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.
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]).
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.