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Acute kidney injury is linked to higher mortality in elderly hospitalized patients with non-valvular atrial fibrillation

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Abstract

Aim

Renal insufficiency is associated with medical complications in patients with non-valvular atrial fibrillation (NVAF). However, data for elderly patients are scarce. Thus, the main objectives of the present study were to analyze the characteristics of elderly patients with NVAF and acute or chronic renal disease, describe their management in real-life conditions, and detect factors associated with complications.

Methods

The NONAVASC registry includes patients > 75 years with NVAF, hospitalized by any cause in 64 Spanish Internal Medicine departments. Patients were categorized into acute kidney injury (AKI), chronic kidney disease (CKD) or preserved renal function (PRF). All variables associated with in-hospital mortality with P < 0.10 in univariate analysis were included to develop a multivariate logistic-regression model.

Results

The study included 804 patients (53.9% women), 352 (43.8%) of whom met diagnostic criteria for CKD. AKI was detected in 119 (14.8%) patients. AKI was associated with greater length of stay, higher mortality and an increased rate of patient transfer to nursing homes. After logistic-regression analysis, we found an association between mortality and AKI (OR 2.4, 95% CI 1.03–5.53; P = 0.045). The increase in creatinine values (OR 1.8, 95% CI 1.19–2.73; P = 0.005) and the decrease in albumin values (OR 2.0, 95% CI 1.05–3.73; P = 0.033) were also linked to mortality.

Conclusions

Our study shows the relationship between AKI and creatinine value increase and a higher mortality in elderly patients with NVAF. In light of our findings, the detection of renal function impairment in these patients should alert physicians and consider them as high-risk patients.

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Acknowledgements

We wish to acknowledge all the investigators of the NONAVASC registry for collecting data for the study.

Author information

Authors and Affiliations

  1. Internal Medicine Department, University Hospital of Santiago de Compostela, 15701, A Coruña, Spain

    Ignacio Novo-Veleiro & Antonio Pose-Reino

  2. Internal Medicine Department, University Hospital of La Princesa, Madrid, Spain

    Alejandra Gullón & Carmen Suárez

  3. Internal Medicine Department, University Hospital Miguel Servet, Zaragoza, Spain

    Jesús Díez-Manglano

  4. Internal Medicine Department, Vega Baja Hospital, Orihuela, Alicante, Spain

    José-María Cepeda

  5. Geriatric Unit, Internal Medicine Department, L’Hospitalet de Llobregat, University Hospital of Bellvitge, Barcelona, Spain

    Francesc Formiga

  6. Internal Medicine Department, Clinic University Hospital, Barcelona, Spain

    Miguel Camafort

  7. Internal Medicine Department, University Hospital of La Paz-Carlos III, Madrid, Spain

    José-María Mostaza

Authors
  1. Ignacio Novo-Veleiro
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  2. Antonio Pose-Reino
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Correspondence to Ignacio Novo-Veleiro.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Novo-Veleiro, I., Pose-Reino, A., Gullón, A. et al. Acute kidney injury is linked to higher mortality in elderly hospitalized patients with non-valvular atrial fibrillation. Aging Clin Exp Res 31, 455–461 (2019). https://doi.org/10.1007/s40520-018-1001-2

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  • DOI: https://doi.org/10.1007/s40520-018-1001-2

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