TITLE:
Incidence, Risk Factors and Short Term Outcome of Acute Kidney Injury among Patients with Acute Coronary Syndrome
AUTHORS:
Md. Kabir Hossain, Muhammad Rafiqul Alam, Asia Khanam, A. K. M. Shahidur Rahman, Rafi Nazrul Islam, Syed Fazlul Islam, Mohammad Kamrul Ahsan, S. K. Mamun-Ar-Rashid, Tanvir Rahman, Md. Nazmul Hasan
KEYWORDS:
Acute Kidney Injury (AKI), Acute Coronary Syndrome (ACS), Cardio-Renal Syndrome
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.8 No.5,
May
21,
2020
ABSTRACT: Background: Cardio-renal syndrome is the leading cause of death globally. Acute kidney injury (AKI) is a major complication among patients admitted in Coronary Care Unit (CCU) with acute coronary syndrome (ACS). AKI in ACS patients is associated with higher morbidity, mortality and prolong hospital stay. Objective: To determine the incidence, risk factors and short term outcome of acute kidney injury (AKI) among the patients admitted in CCU with ACS. Methods: This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to December 2013. Following selection criteria a total of two hundred (200) patients with ACS were studied. AKI was defined according to the KDIGO guideline and further categorized by RIFLE criteria. Data of patients with AKI and those without AKI were analyzed and compared by statistical tests. Results: Majority of the study patients were male (79.5%). AKI was developed in 40 of the 200 study patients (20.0%). The mean (±SD) age of the study patients was 60.1 ± 11.1 years in patients with AKI and 55.9 ± 10.1 years in patients without AKI. Our data analysis showed that older age (>65 years), diabetes mellitus, dyslipidemia and smoking were significantly correlated to the development of AKI. Mortality was significantly high in AKI group (7.15%) compared to no AKI group (1.25%). Out of 27 patients who achieved renal recovery most (80.8%) belonged to risk class. Severity of AKI showed significant effect on renal recovery and final outcome. Conclusion: This study demonstrated that, incidence of AKI among patients with ACS was 20%. Elderly patients, diabetes mellitus, dyslipidemia, and exposure to smoking were significantly associated with development of AKI in ACS.