Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular Disease

Introduction: Acute kidney injury (AKI) is associated with chronic kidney disease (CKD) and cardiovascular disease (CVD); however, it is unclear whether AKI duration affects the long-term risks of CKD and CVD. Therefore, we performed a population-based cohort study examining the associations between...

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Main Authors: Simon K. Jensen, Uffe Heide-Jørgensen, Henrik Gammelager, Henrik Birn, Christian F. Christiansen
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Kidney International Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924000445
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author Simon K. Jensen
Uffe Heide-Jørgensen
Henrik Gammelager
Henrik Birn
Christian F. Christiansen
author_facet Simon K. Jensen
Uffe Heide-Jørgensen
Henrik Gammelager
Henrik Birn
Christian F. Christiansen
author_sort Simon K. Jensen
collection DOAJ
description Introduction: Acute kidney injury (AKI) is associated with chronic kidney disease (CKD) and cardiovascular disease (CVD); however, it is unclear whether AKI duration affects the long-term risks of CKD and CVD. Therefore, we performed a population-based cohort study examining the associations between AKI duration and CKD and CVD. Methods: We identified patients with laboratory-recorded AKI in Denmark from 1990 through 2018. AKIs were categorized as rapid reversal AKI (≤48 hours), persistent AKI (2–7 days), and acute kidney disease (AKD) (>7 days). We estimated 20-year risks and adjusted hazard ratios (aHRs) of incident CKD and CVD. Results: The study comprised 169,582 patients with AKI, with 100,478 and 76,838 included in the analysis of CKD and CVD, respectively. The 20-year risks of CKD were 26.3%, 29.5%, and 28.7% for rapid reversal AKI, persistent AKI, and AKD, respectively. Compared with rapid reversal AKI, aHRs were 1.13 (95% confidence interval [CI], 1.08–1.19) for persistent AKI and 1.36 (95% CI, 1.30–1.41) for AKD. Risks and rates of overall CVD were similar for rapid reversal AKI, persistent AKI, and AKD. However, persistent AKI was associated with a slightly increased aHR of heart failure (1.09; 95% CI, 1.02–1.16), and aHRs of heart failure, ischemic heart disease, and peripheral artery disease were slightly increased for AKD (1.09 [95% CI, 1.03–1.15], 1.11 [95% CI, 1.03–1.19], and 1.10 [95% CI, 1.02–1.17], respectively). Conclusion: AKI duration was associated with development of CKD, but not overall CVD; however, rates of heart failure, ischemic heart disease, and peripheral artery disease increased slightly with AKI duration.
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spelling doaj-art-abd7d0f0129648958d73f22e750783a62025-08-20T03:20:19ZengElsevierKidney International Reports2468-02492024-04-019481782910.1016/j.ekir.2024.01.034Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular DiseaseSimon K. Jensen0Uffe Heide-Jørgensen1Henrik Gammelager2Henrik Birn3Christian F. Christiansen4Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Correspondence: Simon K. Jensen, Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark.Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, DenmarkDepartment of Intensive Care Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartments of Clinical Medicine and Biomedicine, Aarhus University, Aarhus, Denmark; Department of Renal Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, DenmarkIntroduction: Acute kidney injury (AKI) is associated with chronic kidney disease (CKD) and cardiovascular disease (CVD); however, it is unclear whether AKI duration affects the long-term risks of CKD and CVD. Therefore, we performed a population-based cohort study examining the associations between AKI duration and CKD and CVD. Methods: We identified patients with laboratory-recorded AKI in Denmark from 1990 through 2018. AKIs were categorized as rapid reversal AKI (≤48 hours), persistent AKI (2–7 days), and acute kidney disease (AKD) (>7 days). We estimated 20-year risks and adjusted hazard ratios (aHRs) of incident CKD and CVD. Results: The study comprised 169,582 patients with AKI, with 100,478 and 76,838 included in the analysis of CKD and CVD, respectively. The 20-year risks of CKD were 26.3%, 29.5%, and 28.7% for rapid reversal AKI, persistent AKI, and AKD, respectively. Compared with rapid reversal AKI, aHRs were 1.13 (95% confidence interval [CI], 1.08–1.19) for persistent AKI and 1.36 (95% CI, 1.30–1.41) for AKD. Risks and rates of overall CVD were similar for rapid reversal AKI, persistent AKI, and AKD. However, persistent AKI was associated with a slightly increased aHR of heart failure (1.09; 95% CI, 1.02–1.16), and aHRs of heart failure, ischemic heart disease, and peripheral artery disease were slightly increased for AKD (1.09 [95% CI, 1.03–1.15], 1.11 [95% CI, 1.03–1.19], and 1.10 [95% CI, 1.02–1.17], respectively). Conclusion: AKI duration was associated with development of CKD, but not overall CVD; however, rates of heart failure, ischemic heart disease, and peripheral artery disease increased slightly with AKI duration.http://www.sciencedirect.com/science/article/pii/S2468024924000445acute kidney injurycardiovascular diseasechronic kidney diseasedurationpopulation-basedprognosis
spellingShingle Simon K. Jensen
Uffe Heide-Jørgensen
Henrik Gammelager
Henrik Birn
Christian F. Christiansen
Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular Disease
Kidney International Reports
acute kidney injury
cardiovascular disease
chronic kidney disease
duration
population-based
prognosis
title Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular Disease
title_full Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular Disease
title_fullStr Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular Disease
title_full_unstemmed Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular Disease
title_short Acute Kidney Injury Duration and 20-Year Risks of CKD and Cardiovascular Disease
title_sort acute kidney injury duration and 20 year risks of ckd and cardiovascular disease
topic acute kidney injury
cardiovascular disease
chronic kidney disease
duration
population-based
prognosis
url http://www.sciencedirect.com/science/article/pii/S2468024924000445
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