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Original article

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Heart and kidney crosstalk: risk factors, clinical features, and short-term outcomes associated with acute kidney injury in patients suffering acute non-ST elevation myocardial infarction

By
Minela Becirovic ,
Minela Becirovic

Internal Medicine Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Emir Bećirović ,
Emir Bećirović

Internal Medicine Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Semir Hadžić ,
Semir Hadžić

School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina

Lejla Rakovac Tupković ,
Lejla Rakovac Tupković

Department of Clinical Pharmacology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Amir Bećirović ,
Amir Bećirović

Internal Medicine Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Nadina Avdić Jahić ,
Nadina Avdić Jahić

Internal Medicine Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Aida Ribić ,
Aida Ribić

Department of Pediatrics, General Hospital "Prim. Dr. Abdulah Nakaš", Sarajevo, Bosnia and Herzegovina

Lamija Ferhatbegović ,
Lamija Ferhatbegović

Department of Internal Medicine with Haemodialysis, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Amira Jagodić Ejubović ,
Amira Jagodić Ejubović

Department of Internal Medicine with Haemodialysis, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Emir Begagić ,
Emir Begagić

Department of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Daniela Lončar ,
Daniela Lončar

Internal Medicine Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Kenana Ljuca
Kenana Ljuca

Health Centre of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina

Abstract

Aim Acute kidney injury (AKI) presents a high mortality complication in patients with acute myocardial infarction (AMI). Yet, its correlation with non-ST elevation myocardial infarction (NSTEMI) remains neglected in the literature. This study aims to investigate the prevalence, risk factors, clinical features, and short-term outcomes associated with AKI development in patients with acute NSTEMI.
Methods A one-year prospective observational cohort study involved 170 consecutive patients hospitalized in the Intensive Care Department of the Internal Medicine Clinic at the University Clinical Centre Tuzla diagnosed with acute NSTEMI. Patients were subsequently categorized into AKI and non-AKI groups based on AKI development within 48 hours. Demographic characteristics, laboratory findings, and short-term clinical outcomes were compared between the groups.
Results Of 170 patients, 31 (18.2%) developed AKI within 48 hours of acute NSTEMI. Significant age differences, blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), blood glucose level (BGL), C-reactive protein (CRP), and high sensitivity (hs) troponin were observed, making patients with lower baseline kidney function, more extensive myocardial infarction, and a heavier systemic inflammatory response following acute NSTEMI more susceptible to AKI development. In the follow-up period, mortality rates were significantly higher in the AKI group, amounting to 35.5% compared to 10.1% in the non-AKI group. Additionally, mortality increased with the severity of AKI, reaching 100% in AKI stage 2.
Conclusion This study highlights demographic, clinical and laboratory findings in patients with acute NSTEMI, which contribute to AKI development. Early detection and tailored interventions are crucial in mitigating AKI-associated morbidity and mortality.

Author Contributions

Conceptualization, M.B. and E.B.; Methodology, M.B.; Writing – review & editing, M.B.; Supervision, S.H. and E.B.; Data curation, L.R.T. and A.B.; Writing – original draft, L.R.T. and A.B.; Software, N.A.J., A.R., L.F., A.J.E. and D.L.; Visualization, N.A.J., A.R., L.F., A.J.E., D.L. and K.L.; Investigation, K.L. All authors have read and agreed to the published version of the manuscript.

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Funding Statement

No specific funding was received for this study

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

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