2018
EUROPEAN JOURNAL OF HEART FAILURE

Acute kidney injury in cardiogenic shock. definitions, incidence, haemodynamic alterations, and mortality

01 Pubblicazione su rivista
Tarvasmäki T., Haapio M., Mebazaa A., Sionis A., Silva-Cardoso J., Tolppanen H., Lindholm M. G., Pulkki K., Parissis J., Harjola V. -P., Lassus J., Banaszewski M., Kober L., Metra M., Di Somma S., Spinar J., Koniari K., Voumvourakis A., Karavidas A., Sans-Rosello J., Vila M., Duran-Cambra A., Metra M., Bulgari M., Lazzarini V., Parenica J., Stipal R., Ludka O., Palsuva M., Ganovska E., Kubena P., Lindholm M. G., Hassager C., Bäcklund T., Jurkko R., Järvinen K., Nieminen T., Pulkki K.
ISSN: 1388-9842

Aims: To investigate the incidence, haemodynamic alterations and 90-day mortality of acute kidney injury (AKI) in patients with cardiogenic shock. We assessed the utility of creatinine, urine output (UO) and cystatin C (CysC) definitions of AKI in prognostication. Methods and results: Cardiogenic shock patients with serial plasma samples (n = 154) from the prospective multicenter CardShock study were included in the analysis. Acute kidney injury was defined and staged according to the KDIGO criteria by creatinine (AKIcrea) and/or UO (AKIUO). CysC-based AKI (AKICysC) was defined similarly to AKIcrea. Changes in haemodynamic parameters were assessed over time from baseline until 96 h. Mean age of the study population was 66 ± 12 years and 74% were men. Median baseline creatinine was 1.12 [interquartile range (IQR) 0.87–1.54] mg/dL and CysC 1.19 (IQR 0.90–1.69) mg/L. The 90-day mortality was 38%. The incidences for AKI were: AKIcrea 31%, AKIUO 50%, and AKICysc 33%. AKIcrea [odds ratio (OR) 12.2, 95% confidence interval (CI) 4.1–36.0] and AKICysC (OR 2.5, 95% CI 1.1–6.1), but not AKIUO, were independent predictors of mortality. However, a stricter UO cut-off of

acute kidney injury cardiogenic shock haemodynamics kdigo urine output

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