Abstract
Methods A single-center, retrospective and observational trial. All subjects with positive AKI alert, treated at the University Hospital Brandenburg between January and December 2019, were evaluated. Definition of CRS type 3 was according to predefined criteria. The three endpoint categories were in-hospital death, dialysis, and recovery of kidney function. Results . A total number of 1,334 AKI alerts were screened. Finally, 95 subjects received the diagnosis CRS type 3. The survival rates were 47.1% (females) and 43.6% (males). 46.8% of affected females and 33.3% of the males required dialysis therapy. Complete recovery at the time of discharge occurred in 35.8%, and no recovery at all was found in 54.7%. Conclusions . All three predefined study endpoints, the mortality, the prevalence of dialysis, and the percentage of subjects without recovery of kidney function, were notably high. Therefore, AKI patients with imminent or established cardiac complications require the highest attention of nephrologists in charge.
Highlights
In 2008, Ronco et al introduced the concept of cardiorenal syndromes (CRS) [1]. e authors differentiated between five distinct CRS types, all characterized by functional/structural affection of both the heart and kidney in an acute or chronic manner. e general concept was to emphasize the inter-/multidisciplinary character of the diseases, from a pathophysiological and from a therapeutic perspective.In CRS type 3, acute kidney injury (AKI) [2] induces and, sometimes, even perpetuates acute cardiac pathologies such as arrhythmias with or without cardiac decompensation or the latter due to other causes [3]
Every category was tested for the following variables: gender, age, duration of in-hospital stay, AKI stage according to KDIGO [2], initial, peak, and last serum
From the nephrologist’s perspective, three parameters are interesting in CRS type 3: in-hospital mortality, prevalence of renal replacement therapy, and renal recovery until discharge
Summary
In 2008, Ronco et al introduced the concept of cardiorenal syndromes (CRS) [1]. In CRS type 3, acute kidney injury (AKI) [2] induces and, sometimes, even perpetuates acute cardiac pathologies such as arrhythmias with or without cardiac decompensation or the latter due to other causes (e.g., aggravated hypertension and fluid retention) [3]. E actual incidence of AKI-associated cardiac complications (and, of CRS type 3), ranges much higher for sure since other consequences than cardiac death must be considered : pulmonary congestion, arrhythmias of various etiology, pericarditis, and coronary artery insufficiency. In cardiorenal syndrome (CRS) type 3, acute kidney injury (AKI) induces and, sometimes, even perpetuates acute cardiac pathologies such as arrhythmias with or without cardiac decompensation or the latter due to other causes. Epidemiological data on CRS type 3 are limited. e aim of this study was to analyze epidemiological and outcome variables in CRS type
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