title: Relation between transient or persistent acute kidney injury and long-term mortality in patients with myocardial infarction.
abstract: Limited information is available regarding the impact of acute kidney injury (AKI) during hospitalization on clinical outcomes after myocardial infarction (MI), and the effect of transient kidney injury (KI) on long-term mortality has not been validated. We retrospectively analyzed 2,289 patients diagnosed with MI. AKI patients were classified into a transient KI group and a persistent KI group based on serum creatinine levels at discharge. The end point of the study was 3-year mortality after MI. We included 2,110 patients of whom 237 patients (11%) developed AKI during hospitalization. Of these 237 patients, 154 (65%) had transient KI, and 83 (35%) had persistent KI. Multivariate analysis showed that age, left ventricular ejection fraction, estimated glomerular filtration rate on admission, and Killip class were significantly associated with developing AKI during hospitalization. The adjusted hazard ratios for 3-year mortality were 1.71 (95% confidence interval: 1.08-2.70) for AKI patients with transient KI and 2.21 (95% confidence interval: 1.34-3.64) for AKI patients with persistent KI, compared with no AKI. In conclusion, AKI was associated with an increased risk of death for patients who experienced MIs and survived during hospitalization. Although renal function had completely recovered in many AKI patients at discharge, these transient KI patients are also at a great risk of death after MI.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Choi
authors.forename: Young A
authors.initials: YA
authors.lastname: Kim
authors.forename: Min Jee
authors.initials: MJ
authors.lastname: Kim
authors.forename: Yong Un
authors.initials: YU
authors.lastname: Kang
authors.forename: Chang Seong
authors.initials: CS
authors.lastname: Kim
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.forename: Seong Kwon
authors.initials: SK
authors.lastname: Ma
authors.forename: Young-Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality*; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate