AKI and long-term risk for cardiovascular events and mortality

We conducted a systematic review and meta-analysis to assess whether acute kidney injury was associated with long-term cardiovascular disease. We included cohort studies that examined adults with and without acute kidney injury and reported a multivariable adjusted relative risk for the association between acute kidney injury and cardiovascular mortality, major cardiovascular events and disease specific events: congestive heart failure, acute myocardial infarction and stroke. Twenty-five studies involving 254,408 adults (55,150 with acute kidney injury) were included. Acute kidney injury was associated with an 86% and 38% increased risk of cardiovascular mortality and major cardiovascular events respectively (relative risk 1.86, 95% CI: 1.72-2.01 and 1.38, 1.22-1.55). For disease specific events, acute kidney injury was associated with a 58% increased risk of heart failure (1.58, 1.46-1.72) and a 40% increased risk of acute myocardial infarction (1.40, 1.23-1.59). The elevated risk of heart failure and acute myocardial infarction persisted in subgroup analyses based on acute kidney injury severity and the proportion of adults with baseline ischemic heart disease. Finally, acute kidney injury was associated with a 15% increased risk of stroke (1.15, 1.04-1.28). Acute kidney injury is associated with an elevated risk of cardiovascular mortality and major cardiovascular events, particularly heart failure and acute myocardial infarction