MP302RISK ASSESSMENT OF ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE CARDIOVASCULAR DISEASES

Abstract

INTRODUCTION AND AIMS: Study cardiorenal relationship has allowed developing the concept of CKD and acute kidney injury (AKI)Despite recognition that Acute Kidney Injury (AKI) leads to substantial increases in morbidity, mortality, and length of stay, accurate prognostication of these clinical events remains difficult. It remains unclear which approaches to variable selection and model building are most robust. We used data from a randomized trial of AKI alerting to develop time‐updated prognostic models using stepwise regression compared to more advanced variable selection techniques. To identify predictors of different flow options AKI in patients with severe cardiovascular disease and to develop a risk assessment scale of AKI in patients with severe cardiovascular disease. METHODS: The study included 987 people who were 3 groups: those with AD CHF (n = 278) and ACS without ST (n = 288), respectively, were hospitalized in cardiology, therapeutic and Cardiac Intensive Care Unit Moscow Clinical Hospital@64, in the third group consisted of patients with stable CHF (n = 421). Statistical analysis was performed using statistical software application package Statistica 10 and SPSS 22 using standard algorithms of variation statistics. RESULTS: Risk of AKI determined primarily renal function and blood pressure levels, as well as in patients with existing comorbidities. Predictor of outpatient AKI, moreover, it was alcohol abuse (OR 2.31, 95% CI 1,4‐3,81, p <0.001), and for the hospital AKI ‐ appointment of loop diuretics (OR 2.32, 95% CI 1,53‐3,51, p <0.001) and veroshpiron (OR 2.04, 95% CI 1,35‐3,09, p <0.001) in the hospital, age older than 80 years (OR 1.78, 95% 1,12‐2,8 CI, p <0.05). Predictors of persistence AKI had LVEF <35% (OR 2.12, 95% CI 1, 24‐3,62, p <0.001), the appointment veroshpirona (OR 2.12, 95% CI 1,37‐3,28, p <0.001) and loop diuretics (OR 2.66, 95% CI 1,71‐4,14, p <0.001) for the first time in the hospital, as compared to its transitory nature ‐ SBP at admission> 180 mm Hg. Art. (OR 4.42, 95% CI 1,22‐15,95, p <0.05). Thus obtained predictors were included in the regression model, the predictive power of which amounted to 88.5%. Scale was developed risk assessment of AKI, which is based on the values of the regression coefficient B (area under the curve of 0.860). As a result of the sum of points on the selected risk assessment scale AKI for each patient was built ROC curve, the area under the curve was 0.860, which is rated as very good quality model. CONCLUSIONS: The most significant risk factors for ACS are signs of impaired renal function and low levels of SBP at admission, anemia, or AHF or AD CHF, alcohol, appointment veroshpiron and loop diuretics for the first time in the hospital, IHD, CKD, with type 2 diabetes. The specific predictors for patients with AD CHF are the absence of β‐blocker therapy in the outpatient phase, the high status of hydration and history of hospitalizations for heart failure decompensation during the last year, and for patients with ACS without elevation ST ‐ old age, hypoglycemia admission and development of MI in the outcome of ACS.