Similar mortality rates found for community-acquired, hospital-acquired acute kidney injury

PHILADELPHIA — Acute kidney injury is common, and community-acquired and hospital-acquired acute kidney injury lead to similar mortality rates, according to a speaker here.

“Acute kidney injury is not just an in-hospital syndrome, and it is suggested that it can occur from infections from primary care, outpatient procedures and inpatient procedures,” Peter A. McCullough, MD, MPH, of Baylor University Medical Center, said. “Multiple studies have demonstrated that roughly one-third of acute kidney injury cases result in some underlying cause of worsening of kidney disease.”

One recent study showed that mortality was similar between patients with community-acquired (66.1%) and hospital-acquired acute kidney injury (69%), and another revealed that 25% of patients with acute kidney injury were hospitalized within 12 months with acute kidney injury at a median of 64 days, according to McCullough.

In terms of heart failure and kidney disease, a growing body of literature suggests that pulmonary congestion is part of the cardiorenal syndrome and may contribute to chronic lung disease, McCullough said.

“The bottom line is that there is a narrow window for treatment in a patient with heart failure and chronic kidney disease, but guided diuretic management may be beneficial,” he said.

McCullough added that renin-angiotensin-aldosterone system inhibitor agents may be a “cornerstone of chronic therapy” for chronic kidney disease and heart failure, but these may present hazards in the acute setting.

“Severe hyperkalemia is also a consequence of acute kidney injury, and it may be preventable and better managed with new therapeutic agents,” McCullough said. “What may help us in the future are drugs that can keep the calcium under control.” – by Amber Cox

Reference:

McCullough PA. The Cardio-Renal Syndrome. Presented at: Heart in Diabetes Clinical Education Conference; July 14-16, 2017; Philadelphia.

Disclosures: Endocrine Today was unable to confirm any relevant financial disclosures.