Acute and Chronic Cardiovascular Consequences of Acute Kidney Injury: A Systematic Review and Meta-Analysis
Notice bibliographique
Résumé
INTRODUCTION: We examined whether patients with acute kidney injury (AKI) have a higher risk of developing atrial fibrillation (AF), heart failure (HF), acute coronary syndrome (ACS), and major adverse cardiac events (MACE) in the short and long term compared to patients without AKI, and if that risk is related to the severity of AKI. Furthermore, we investigated the influence of a cardiac event following AKI on the risk of all-cause mortality, length of stay in the intensive care unit and in the hospital. METHODS: We included English and Dutch retrospective and prospective cohort studies on adults (≥15 years) with AKI. Studies lacking epidemiological data, studies not using the consensus definitions (RIFLE, AKIN, KDIGO), animal studies, and studies on children were excluded. Studies were identified using the PubMed and Embase search engines. The last search was performed on the first of August 2021. For assessment of method quality, Newcastle-Ottawa Scale (NOS) for assessing risk of bias was used for cohort studies and heterogeneity was determined by the I2 statistic. Statistical analysis was performed using the Cochrane Review Manager (RevMan 5.3). The risk ratio (RR) and 95% confidence interval (CI) were calculated using the Mantel-Haenszel test. Results were presented in a summary caterpillar plot. RESULTS: We evaluated 14 studies comprising 736,210 patients. AKI was defined according to the RIFLE consensus in 1 article, to the AKIN criteria in 7, and to the KDIGO guidelines in 6. Of the 14 included studies, 4 were prospective and 10 were retrospective. In comparison with patients without AKI, we found that patients with AKI had a 94% increased risk of developing AF in the short term (RR: 1.94, 95% CI 1.35-2.79; p = 0.0004). In the long term, patients with AKI stage 1 had a 59% increased risk of developing HF and a 77% risk of developing ACS (RR: 1.59, 95% CI 1.07-2.34, p = 0.02 and RR: 1.77, 95% CI 1.68-1.88, p < 0.00001, respectively). Patients with AKI stage 2 had a 45% increased risk of ACS development (RR: 1.45, 95% CI 1.11-1.90, p = 0.006). AKI stage 3 was associated with a 164% increased risk of HF and a 95% increased risk of ACS development (RR: 2.64, 95% CI 1.71-4.08, p < 0.00001 and RR: 1.95, 95% CI 1.35-2.82, p = 0.0004, respectively). Analysis of studies not subdividing AKI into groups showed a 74% increased risk of HF, a 12% increased risk of ACS, and a 30% increased risk of developing MACE (RR: 1.74, 95% CI 1.51-2.01, p < 0.00001, RR: 1.12, 95% CI 1.07-1.17, p < 0.00001 and RR: 1.30, 95% CI 1.25-1.35, p < 0.00001, respectively). CONCLUSIONS: Patients who developed AKI have an increased risk of developing AF at short-term follow-up and HF, ACS, and MACE beyond 30 days.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,036 | 0,008 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,002 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».