Ulyanovsk Medico-biological Journal

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ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

M.V. Menzorov, A.M. Shutov, E.R. Makeeva, A.A. Strahov, E.V. Mihailova

Ulyanovsk State University

 

The purpose of this study was to examine the incidence of the acute kidney injury (AKI), defined by the RIFLE criteria and the AKIN criteria in patients with acute decompensated heart failure. Creatinine criteria led to a maximum RIFLE and a maximum AKIN in 56 % and 71 % of patients, respectively. AKI defined by RIFLE criteria (Class I, F) and AKIN (Stage 2, 3) criteria was associated with inhospital mortality.

Keywords: acute decompensated heart failure, acute kidney injury, RIFLE criteria, AKIN criteria.

 

References

  1. Митральная регургитация у больных с хронической сердечной недостаточностью ассоциирована со снижением функционального состояния почек / А.М. Шутов и др. // Нефрология. – 2008. – №12. – C. 19–23.

  2. Национальные рекомендации ВНОК и ОССН по диагностике и лечению хронической сердечной недостаточности // Сердечная недостаточность. – 2010. – Т. 57, №1.

  3. Национальные рекомендации по диагностике и лечению острой сердечной недостаточности // Кардиоваскулярная терапия и профилактика. – 2006. – Т. 6, №5. Прил. 1.

  4. Острое повреждение почек у больных инфарктом миокарда и эффективность тромболитической терапии / М.В. Мензоров и др. – Кардиология. – 2012. – №5. – С. 8–12.

  5. Острое повреждение почек у больных инфарктом миокарда с подъемом сегмента ST / М.В. Мензоров и др. // Нефрология. – 2012. – №1. – С. 40–44.

  6. Acute heart failure syndromes: clinical scenarios and pathophysiologic targets for therapy / L. De Luca et al. // Heart Fail Rev. – 2007. – Vol. 12. – P. 97–104.

  7. Acute kidney injury classification: compa-rison of AKIN and RIFLE criteria / C.H. Chang et al. // Shock. – 2010. – Vol. 33. – P. 247–252.

  8. Acute kidney injury in tropical acute febrile illness in a tertiary care centre–RIFLE criteria vali-dation / G. Basu et al. // Nephrol. Dial. Transplant. – 2011. – Vol. 26. – P. 524–531.

  9. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury / R.L. Mehta et al. // Crit. Care. – 2007. – Vol. 11. – P. 31.

  10. Acute kidney injury, mortali-ty, length of stay, and costs in hospitalized patients / G.M. Cher-tow et al. // J. Am. Soc. Nephrol. – 2005. – Vol. 16. – P. 3365–3370.

  11. Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score / A. De Mendonca et al. // Intensive Care Med. – 2000. – Vol. 26. – P. 915–921.

  12. Acute renal failure-definition, outcome mea-sures, animal models, fluid therapy and information technology needs: the Second International Consen-sus Conference of the Acute Dialysis Quality Initiati-ve (ADQI) Group / R. Bellomo et al. // Crit. Care. – 2004. – Vol. 8. – P. 204–212.

  13. Bagshaw, S.M. A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients / S.M. Bagshaw, C. George, R. Bellomo // Nephrol. Dial. Transplant. – 2008. – Vol. 23. – P. 1569–1574.

  14. Chenoweth, C.E. Urinary tract infections / C.E. Chenoweth, S. Saint // Infectious Disease Clinics of North America. – 2011. – Vol. 25. – P. 103–115.

  15. Clinical accuracy of RIFLE and Acute Kid-ney Injury Network (AKIN) criteria for acute kidney injury in patients undergoing cardiac surgery / L. Engl-berger et al. // Crit. Care. – 2011. – Vol. 15. – P. 16.

  16. Commonly used surrogates for baseline renal function affect the classification and prognosis of acute kidney injury / E.D. Siew et al. // Kidney Int. – 2010. – Vol. 77. – P. 536–542.

  17. Defining acute kidney injury: playing hide-and-seek with the unknown man? / W.V. Biesen et al. // Nephrol. Dial. Transplant. – 2011. – Vol. 26. – P. 399–401.

  18. Defining urine output criterion for acute kidney injury in critically ill patients / E. Macedo et al. // Nephrol. Dial. Transplant. – 2011. – Vol. 26. – P. 509–515.

  19. Does furosemide prevent renal dysfunction in high-risk cardiac surgical patients? Results of a double-blinded prospective randomised trial / B. Ma-hesh et al. // Eur. J. Cardiothorac. Surg. – 2008. – Vol. 33. – P. 370–376.

  20. Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Complications and Mortali-ty in Patients Undergoing Non-Cardiac Major Surgery / L. Shavit et al. // Kidney Blood Press Res. – 2011. – Vol. 34. – P. 116–124.

  21. Predicting mortality among patients hospita-lized for heart failure: derivation and validation of a clinical model / D.S. Lee et al. // J. Am. Med. Assoc. – 2003. – Vol. 290. – P. 2581–2587.

  22. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis / E.A. Hoste et al. // Crit. Care. – 2006. – Vol. 10. – P. R73.

  23. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis / G.C. Fonarow et al. // J. Am. Med. Assoc. – 2005. – Vol. 293. – P. 572–580.

  24. Self, W.H. Novel biomarkers: help or hind-rance to patient care in the emergency department? / W.H. Self, T.W. Barrett // Ann. Emerg. Med. – 2010. – Vol. 56. – P. 60–61.

  25. Supportive Therapy for the Kid-ney (BEST Kidney) Investigators. Acute renal failure in critically ill patients: a multinational, multicenter study / S. Uchino et al. // JAMA. – 2005. – Vol. 294. – P. 813–818.

  26. The association between congestive heart failure and chronic renal disease / D. Silverberg et al. // Curr. Opin. Nephrol. Hypertens. – 2004. – Vol. 13. – P. 163–170.

  27. Urinary biomarkers in the clini-cal prognosis and early detection of acute kidney injury / J.L. Koyner et al. // Clin. J. Am. Soc. Nephrol. – 2010. – Vol. 5. – P. 2154–2165

 

 

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УДК 616.61:616.127-005.8.

ОСТРОЕ ПОВРЕЖДЕНИЕ ПОЧЕК У БОЛЬНЫХ С ОСТРОЙ ДЕКОМПЕНСАЦИЕЙ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ

М.В. Мензоров, А.М. Шутов, Е.Р. Макеева, А.А. Страхов, Е.В. Михайлова

Ульяновский государственный университет

 

В работе изучены частота и выраженность острого повреждения почек (ОПП) по критериям RIFLE и AKIN у больных с острой декомпенсацией хронической сердечной недостаточности (ОДСН). Обнаружено, что более половины больных ОДСН имеют острое повреждение почек по критериям RIFLE и AKIN по креатинину сыворотки. В случае когда при диагностике острого повреждения почек больные с R-классом тяжести по RIFLE и 1 стадией по классификации AKIN не учитывались, ОПП выявлялось более чем в 2 раза реже, а внутригоспитальная летальность была выше, чем у больных без ОПП.

Ключевые слова: острая декомпенсация хронической сердечной недостаточности, острое повреждение почек, критерии RIFLE, критерии AKIN.

 

Литература

  1. Митральная регургитация у больных с хронической сердечной недостаточностью ассоциирована со снижением функционального состояния почек / А.М. Шутов и др. // Нефрология. – 2008. – №12. – C. 19–23.

  2. Национальные рекомендации ВНОК и ОССН по диагностике и лечению хронической сердечной недостаточности // Сердечная недостаточность. – 2010. – Т. 57, №1.

  3. Национальные рекомендации по диагностике и лечению острой сердечной недостаточности // Кардиоваскулярная терапия и профилактика. – 2006. – Т. 6, №5. Прил. 1.

  4. Острое повреждение почек у больных инфарктом миокарда и эффективность тромболитической терапии / М.В. Мензоров и др. – Кардиология. – 2012. – №5. – С. 8–12.

  5. Острое повреждение почек у больных инфарктом миокарда с подъемом сегмента ST / М.В. Мензоров и др. // Нефрология. – 2012. – №1. – С. 40–44.

  6. Acute heart failure syndromes: clinical scenarios and pathophysiologic targets for therapy / L. De Luca et al. // Heart Fail Rev. – 2007. – Vol. 12. – P. 97–104.

  7. Acute kidney injury classification: compa-rison of AKIN and RIFLE criteria / C.H. Chang et al. // Shock. – 2010. – Vol. 33. – P. 247–252.

  8. Acute kidney injury in tropical acute febrile illness in a tertiary care centre–RIFLE criteria vali-dation / G. Basu et al. // Nephrol. Dial. Transplant. – 2011. – Vol. 26. – P. 524–531.

  9. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury / R.L. Mehta et al. // Crit. Care. – 2007. – Vol. 11. – P. 31.

  10. Acute kidney injury, mortali-ty, length of stay, and costs in hospitalized patients / G.M. Cher-tow et al. // J. Am. Soc. Nephrol. – 2005. – Vol. 16. – P. 3365–3370.

  11. Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score / A. De Mendonca et al. // Intensive Care Med. – 2000. – Vol. 26. – P. 915–921.

  12. Acute renal failure-definition, outcome mea-sures, animal models, fluid therapy and information technology needs: the Second International Consen-sus Conference of the Acute Dialysis Quality Initiati-ve (ADQI) Group / R. Bellomo et al. // Crit. Care. – 2004. – Vol. 8. – P. 204–212.

  13. Bagshaw, S.M. A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients / S.M. Bagshaw, C. George, R. Bellomo // Nephrol. Dial. Transplant. – 2008. – Vol. 23. – P. 1569–1574.

  14. Chenoweth, C.E. Urinary tract infections / C.E. Chenoweth, S. Saint // Infectious Disease Clinics of North America. – 2011. – Vol. 25. – P. 103–115.

  15. Clinical accuracy of RIFLE and Acute Kid-ney Injury Network (AKIN) criteria for acute kidney injury in patients undergoing cardiac surgery / L. Engl-berger et al. // Crit. Care. – 2011. – Vol. 15. – P. 16.

  16. Commonly used surrogates for baseline renal function affect the classification and prognosis of acute kidney injury / E.D. Siew et al. // Kidney Int. – 2010. – Vol. 77. – P. 536–542.

  17. Defining acute kidney injury: playing hide-and-seek with the unknown man? / W.V. Biesen et al. // Nephrol. Dial. Transplant. – 2011. – Vol. 26. – P. 399–401.

  18. Defining urine output criterion for acute kidney injury in critically ill patients / E. Macedo et al. // Nephrol. Dial. Transplant. – 2011. – Vol. 26. – P. 509–515.

  19. Does furosemide prevent renal dysfunction in high-risk cardiac surgical patients? Results of a double-blinded prospective randomised trial / B. Ma-hesh et al. // Eur. J. Cardiothorac. Surg. – 2008. – Vol. 33. – P. 370–376.

  20. Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Complications and Mortali-ty in Patients Undergoing Non-Cardiac Major Surgery / L. Shavit et al. // Kidney Blood Press Res. – 2011. – Vol. 34. – P. 116–124.

  21. Predicting mortality among patients hospita-lized for heart failure: derivation and validation of a clinical model / D.S. Lee et al. // J. Am. Med. Assoc. – 2003. – Vol. 290. – P. 2581–2587.

  22. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis / E.A. Hoste et al. // Crit. Care. – 2006. – Vol. 10. – P. R73.

  23. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis / G.C. Fonarow et al. // J. Am. Med. Assoc. – 2005. – Vol. 293. – P. 572–580.

  24. Self, W.H. Novel biomarkers: help or hind-rance to patient care in the emergency department? / W.H. Self, T.W. Barrett // Ann. Emerg. Med. – 2010. – Vol. 56. – P. 60–61.

  25. Supportive Therapy for the Kid-ney (BEST Kidney) Investigators. Acute renal failure in critically ill patients: a multinational, multicenter study / S. Uchino et al. // JAMA. – 2005. – Vol. 294. – P. 813–818.

  26. The association between congestive heart failure and chronic renal disease / D. Silverberg et al. // Curr. Opin. Nephrol. Hypertens. – 2004. – Vol. 13. – P. 163–170.

  27. Urinary biomarkers in the clini-cal prognosis and early detection of acute kidney injury / J.L. Koyner et al. // Clin. J. Am. Soc. Nephrol. – 2010. – Vol. 5. – P. 2154–2165