• Jacob C Jentzer, Thomas Breen, Mandeep Sidhu, Gregory W Barsness, and Kianoush Kashani.
• Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America. Electronic address: jentzer.jacob@mayo.edu.
• J Crit Care. 2020 Dec 1; 60: 127-134.

PurposeTo describe the epidemiology and outcomes of acute kidney injury (AKI) among contemporary non-surgical cardiac intensive care unit (CICU) patients.Materials And MethodsWe reviewed adult non-surgical CICU patients admitted from 2007 to 2015. The highest AKI stage during hospitalization was defined using modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria, based on changes in serum creatinine. Hospital and 5-year mortality were examined using logistic regression and Cox proportional-hazards models, respectively.ResultsWe included 9311 patients with a mean age of 67.5 years, including 37% females. AKI was present in 51%: stage 1 AKI in 34%, stage 2 AKI in 9%, and stage 3 AKI in 8%. Hospital mortality was associated with AKI stage (adjusted OR for each AKI stage 1.17, 95% CI 1.04-1.31, p = 0.007). Five-year mortality was incrementally associated with AKI stage (adjusted HR per AKI stage 1.13, 95% CI 1.08-1.18; p < 0.001), particularly post-discharge mortality among hospital survivors (adjusted HR per AKI stage 1.20, 95% CI 1.15-1.25, p < 0.001). Patients with stage 3 AKI (especially requiring dialysis) had the highest adjusted hospital and five-year mortality.ConclusionAKI severity is incrementally associated with higher short-term and long-term mortality in CICU patients, especially severe AKI requiring dialysis.Copyright © 2020 Elsevier Inc. All rights reserved.

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