Frequency and outcomes of acute kidney injury in patients presenting with acute heart failure at a cardiac centre in Karachi

Acute kidney injury in patients presenting with acute heart failure

Abstract

Objectives: To determine the frequency of acute kidney injury (AKI) in patients with acute heart failure (AHF) and evaluate its association with in-hospital mortality.

Patients and Methods: This cross-sectional study was conducted over six months at Tabba Heart Institute, Karachi. A total of 121 consecutive patients aged 40–80 years admitted with AHF were enrolled. Patients with acute coronary syndromes, sepsis, arrhythmias, or major non-cardiac comorbidities were excluded. AKI was defined as a ≥0.3 mg/dL increase in serum creatinine within 48 hours of admission. Demographic, clinical, and socioeconomic variables were recorded. Primary outcomes were the frequency of AKI and in-hospital mortality.

Results: Nineteen patients (15.7%) developed AKI. Patients with AKI had a higher prevalence of urban residence (100% vs 80.4%, p=0.035), dyslipidemia (73.7% vs 44.1%, p=0.018), and reported lower family income (73.7% vs 34.3%, p=0.001) compared to non-AKI patients. In-hospital mortality was higher in the AKI group (42.1% vs 20.6%, p=0.044). Univariate logistic regression showed an odds ratio (OR) for mortality with AKI of 3.05 (95% CI 1.03–9.05, p=0.044). After adjustment, the adjusted OR was 3.21 (95% CI 0.73–14.18, p=0.124)

Conclusion: AKI occurred in approximately one-sixth of patients hospitalized with AHF and was associated with higher unadjusted in-hospital mortality. Socioeconomic factors, particularly low income and urban residence, were linked to AKI risk, underscoring the need for targeted preventive strategies in high-risk subgroups.