Acute and Chronic Cardiovascular Consequences of Acute Kidney Injury: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.036 | 0.008 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".