Abstract
Background
Renal artery stenosis (RAS) is known to co-exist with heart failure (HF), however
the impact of RAS on rates of acute kidney injury during an acute HF hospitalization,
and adverse events after acute HF hospitalizations has not been well studied.
Methods
We performed a retrospective cohort study of subjects hospitalized for acute HF at
a tertiary academic care center. We identified subjects who had a renal artery duplex
ultrasound or other diagnostic study for RAS to categorize heart failure subjects
as RAS+ or RAS-. AKI was defined as a rise from admission to peak creatinine of >0.3
mg/dL or >1.5 fold. In-hospital outcomes including rates of AKI were ascertained.
Adverse outcomes over a two-year follow up period were also ascertained.
Results
A total of 93 subjects with acute HF hospitalization met the inclusion criteria and
were enrolled in this study; 27 (29%) were identified as RAS+. At admission, subjects
with RAS had higher rates of diabetes and prior PCI. During the HF hospitalization,
subjects with RAS were more likely to develop AKI. No significant differences were
identified in baseline or hospital medication use among subjects with versus without
RAS. Importantly, the rate of ACE-I/ARB use was low in both groups and no significant
difference in ACE-I/ARB use was demonstrated. Subjects with RAS had higher rates of
recurrent HF hospitalization during the follow-up period.
Conclusions
RAS is prevalent among subjects with acute HF, associated with higher rates of AKI
during HF hospitalization, and associated with higher rates of recurrent HF hospitalization
during follow-up.
Key Indexing Terms
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Article info
Publication history
Published online: October 16, 2022
Accepted:
October 12,
2022
Received:
October 22,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
