Hashim Ahmed, Maraey Ahmed, Elzanaty Ahmed, Zordok Magdi, Elsharnoby Hadeer, Khalil Mahmoud, Al Wahadneh Omar, Siragy Helmy
Ain Shams University, Faculty of Medicine, Cairo, Egypt.
Department of Internal Medicine, Carle Foundation Hospital, Urbana, IL.
Curr Probl Cardiol. 2023 Oct;48(10):101816. doi: 10.1016/j.cpcardiol.2023.101816. Epub 2023 May 19.
Nonalcoholic fatty liver disease (NAFLD) has been associated with the progression of chronic kidney disease. However, limited data is available on its impact on acute kidney injury (AKI) in heart failure(HF) patients. All primary adult HF admissions from the national readmission database of 2016-2019 were identified. Admissions from July to December of each year were excluded to allow 6 months of follow-up. Patients were stratified according to the presence of NAFLD. Complex multivariate cox regression was used to adjust for confounders and calculate the adjusted hazard ratio. A total of 420,893 weighted patients admitted with HF were included in our cohort, of whom 780 had a secondary diagnosis of NAFLD. Patients with NAFLD were younger, more likely to be female, and had higher rates of obesity and diabetes mellitus. Both groups had similar rates of chronic kidney disease irrespective of the stage. NAFLD was associated with an increased risk of 6-month readmission with AKI (26.8% vs 16.6%, adjusted hazard ratio:1.44, 95% CI [1.14-1.82], P = 0.003). The mean time to AKI readmission was 150 ± 44 days. NAFLD was associated with a shorter mean time to readmission (145 ± 45 vs 155 ± 42 days, β = -10 days, P = 0.044). Our study from a national database suggests that NAFLD is an independent predictor of 6-months readmission with AKI in patients admitted with HF. Further research is warranted to validate these findings.
非酒精性脂肪性肝病（NAFLD）与慢性肾脏病的进展相关。然而，关于其对心力衰竭（HF）患者急性肾损伤（AKI）影响的数据有限。我们从2016 - 2019年国家再入院数据库中识别出所有成年原发性HF住院患者。排除每年7月至12月的住院病例，以便进行6个月的随访。根据是否存在NAFLD对患者进行分层。采用复杂多变量Cox回归调整混杂因素并计算调整后的风险比。我们的队列共纳入420,893例加权的HF住院患者，其中780例有NAFLD的二级诊断。患有NAFLD的患者更年轻，女性比例更高，肥胖和糖尿病发生率更高。两组慢性肾脏病的发生率相似，与分期无关。NAFLD与AKI导致的6个月再入院风险增加相关（26.8%对16.6%，调整后的风险比：1.44，95%可信区间[1.14 - 1.82]，P = 0.003）。AKI再入院的平均时间为150±44天。NAFLD与再入院的平均时间较短相关（145±45对155±42天，β = -10天，P = 0.044）。我们基于国家数据库的研究表明，NAFLD是HF住院患者因AKI导致6个月再入院的独立预测因素。有必要进行进一步研究以验证这些发现。
