Risk Factors For Acute Kidney Injury In Patients With Acute Left Heart Failure

Objective:To investigate the incidence of acute kidney injury(AKI)in patients with acute left heart failure,and to explore the risk factors of AKI in patients with acute left heart failure.Thereby identifying high-risk patients and guiding clinical work.Methods:According to the inclusion and exclusion criteria,a total of 200 patients with acute left heart failure admitted to the Department of Cardiology and ICU from the First Affiliated Hospital of Soochow University from January 2017 to December 2017 were enrolled.Based on the occurrence of AKI,the patients were divided into AKI group and non-AKI group.The clinical data(epidemiological data,laboratory and auxiliary examination,treatment and prognosis)were collected according to the study.Risk factors for acute left heart failure complicated with AKI were analyzed by univariate and multivariate logistic regression.Data were analyzed using SPSS 20.0 statistical software.Results:1.Among the 200 patients with acute left heart failure,91 patients developed AKI(AKI group),accounting for 45.5%.109 patients did not have AKI(non-AKI group),accounting for 54.5%.Among these patients,72 cases were in AKI stage 1,14 cases in AKI stage 2,5 cases of AKI stage 32.Coronary heart disease was the main cause of acute left heart failure,accounting for 65%.Other causes were cardiomyopathy,hypertensive heart disease,rheumatic heart disease,and myocarditis.3.Compared with non-AKI group,factors such as age,coronary heart disease,NE,RDW,BUN,Scr,NT-BNP,hs-CRP in AKI group were significantly higher(P<0.05).While factors such as diastolic pressure at admission,RBC,Hb,eGFR,and LVDd in AKI group were less than the non-AKI group(P<0.05).4.Compared with non-AKI group,the AKI patients had significantly longer hospitalization,higher anti-platelet drugs,lower rate of improvement,higher rate of automatic discharge and mortality(P<0.05).There were no significant differences in the usage rate of ACEI/ARB,diuretic,lipid-regulated drugs,and renal replacement therapy.5.Logistic regression showed that age,high RDW,low eGFR,and high NT-BNP were independent risk factors for AKI in patients with acute left heart failure.Conclusion:The incidence of AKI was significantly higher in patients with acute left heart failure,and was mainly in AKI1 stage.Patients with acute left heart failure were at high risk of developing AKI.Logistic regression showed that age,high RDW,low eGFR,and high NT-BNP were independent risk factors for AKI in patients with acute left heart failure.This findings will help clinicians identify high-risk patients and take preventive measures earlier.