Analysis of the clinical features and risk factors of kidney injury in patients with chronic heart failure—a retrospective cohort study

BACKGROUND: Heart failure (HF) often leads to kidney injury and increased morbidity and mortality. Factors contributing to kidney injury in HF patients had not been elucidated completely. This study sought to comprehensively evaluate the risk factors and clinical features of kidney injury in patients with chronic heart failure (CHF) and to provide more evidence for the management of these patients. METHODS: Adult patients with CHF admitted to Beijing Anzhen Hospital, Capital Medical University from January 2022 to May 2022 were included in this study. The primary endpoints were the independent risk factors for the development of kidney injury. A multivariate logistic regression model was used for the exploration of the risk factors. RESULTS: A total of 193 patients were included in this study, of whom 86 (44.5%) developed kidney injury. The independent risk factors for kidney injury in patients with CHF included sex (male) [odds ratio (OR): 4.30, 95% confidence interval (CI): 1.72–10.7, P=0.001], hypertension (OR: 3.68, 95% CI: 1.64–8.29, P=0.001), and stroke (OR: 3.82, 95% CI: 1.25–11.6, P=0.01). Kidney injury was significantly positively correlated with age (OR: 1.03, 95% CI: 1.008–1.06, P=0.01) and potassium (OR: 3.70, 95% CI: 1.58–8.67, P=0.002), and significantly negatively correlated with angiotensin receptor blocker (ARB) application (OR: 0.26, 95% CI: 0.11–0.61, P=0.001), serum albumin concentration (OR: 0.88, 95% CI: 0.81–0.96, P=0.005), hemoglobin concentration (OR: 0.97, 95% CI: 0.95–0.99, P=0.006), and left ventricular ejection fraction (LVEF; OR: 0.95, 95% CI: 0.92–0.98, P=0.01). CONCLUSIONS: Kidney injury occurred in more than half of the patients with CHF during hospitalization. The independent risk factors for kidney injury in the CHF patients included sex (male), hypertension, and stroke. Kidney injury was positively correlated with age and serum potassium, and negatively correlated with serum albumin, hemoglobin concentration, LVEF, and ARB application.