Acute kidney injury was associated with an 86% increased risk of cardiovascular mortality (RR 1.86) and a 38% increased risk of major cardiovascular events compared to adults without AKI.
Meta-Analysis (n=254,408)
Does acute kidney injury increase the long-term risk of cardiovascular mortality and major cardiovascular events in adults?
Acute kidney injury is significantly associated with an elevated long-term risk of cardiovascular mortality and major cardiovascular events, particularly heart failure and acute myocardial infarction.
Relative Risk: 1.86 (95% CI 1.72–2.01)
AKI associates with increased long-term risk of mortality, but the prognostic significance of AKI in terms of long-term cardiovascular disease remains unconfirmed. We conducted a systematic review and meta-analysis to assess whether AKI associates with long-term cardiovascular disease. We included cohort studies that examined adults with and without AKI and reported a multivariable-adjusted relative risk (RR) for the association between AKI and cardiovascular mortality, major cardiovascular events, and disease-specific events: congestive heart failure, acute myocardial infarction, and stroke. Twenty-five studies involving 254,408 adults (55,150 with AKI) were included. AKI associated with an 86% and a 38% increased risk of cardiovascular mortality and major cardiovascular 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). 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 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 acute myocardial infarction persisted in subgroup analyses on the basis of AKI severity and the proportion of adults with baseline ischemic heart disease. Finally, AKI was associated with a 15% increased risk of stroke (RR 1.15; 95% CI, 1.03 to 1.28). In conclusion, AKI associates with an elevated risk of cardiovascular mortality and major cardiovascular events, particularly heart failure and acute myocardial infarction.
Odutayo et al. (2016) conducted a meta-analysis in Acute Kidney Injury (n=254,408). Acute Kidney Injury vs. No Acute Kidney Injury was evaluated on Cardiovascular mortality (RR 1.86, 95% CI 1.72 to 2.01). Acute kidney injury was associated with an 86% increased risk of cardiovascular mortality (RR 1.86) and a 38% increased risk of major cardiovascular events compared to adults without AKI.