Abstract 14041: The Heart and Kidney Cross-Talk: A Significant Increasing Trend of Heart Failure Patients With Comorbid Acute Kidney Failure and Chronic Kidney Disease in the United States
BACKGROUND AND OBJECTIVES: Around 5.7 million people in the United States have heart failure (HF). HF is the primary cause of more than 550,000 deaths each year in the nation. However, little attention has been paid to the complex and serious association between HF and kidney disease (KD). In this study, we aimed to examine the recent trend of the prevalence of hospitalized HF patients with comorbid KD, and its association with risk of 30-day in-hospital mortality using national survey data.
METHODS: Patients (n=996,147) aged ≥35 years old with primary diagnosis of HF (reason for hospitalization) in the Nationwide Inpatient Sample from 2006 to 2010 were analyzed. Comorbid KD including acute kidney failure (AKF), chronic kidney disease (CKD) and all other forms of KD were defined for HF patients with secondary to sixth diagnosis of KD on the basis of ICD-9 codes.
RESULTS: Age-adjusted prevalence of hospitalized HF patients with comorbid AKF significantly increased from 7.53% in 2006 to 17.49% in 2010 in males (p<0.0001), and from 6.66% to 15.89% in females (p<0.0001). HF patients with comorbid CKD had a smaller increase but remained significant from 15.55% in 2006 to 16.95% in 2010 in male, and from 15.04% to 16.41% in female. Multivariate logistic regression analysis indicated that HF patients with coexisting AKF had 3.30 time higher risk of 30-day in-hospital mortality than those without AKF (95% CI: 2.90-3.76), and the odds of coexisting CKD for death was 1.15 (1.11-1.19). The risk of 30-day in-hospital mortality among HF patients with KD was also significantly associated with hospital status. Patients admitted to rural and urban non-teaching hospitals had significantly higher mortality than those in admitted to urban teaching hospitals. Patients admitted to the hospital between January and March had 15% higher risk of death than those admitted between July and September.
CONCLUSION: Using nationally representative data, the present study is the first to examine and highlight a significantly increasing trend of the prevalence of HF patients with coexisting AKF and CKD. Advanced prevention and improvement of the capacity of healthcare must be considered in order to stop this unfavorable trend.
- © 2013 by American Heart Association, Inc.