Incidence, mortality, and predictors of acute kidney injury in patients with heart failure: a systematic review

Abstract Acute kidney injury (AKI) is common in patients with heart failure (HF), but studies have been inconsistent about the incidence of AKI in patients with HF. We conducted a meta‐analysis to examine the incidence of AKI and its impact on mortality in patients with HF. We also looked at inpatient variables that could predict the development of AKI to identify potential risk factors, so that these can be used as a starting point for intervention and prevention in this group. The Embase, Medline, PubMed, Cochrane libraries, and Web of Science databases were used for searching articles from the inception of the database to October 2022. The EndNote software was used for screening. Meta‐analysis was performed using Stata 16.0 software to combine effect sizes. A total of 37 studies were included. Of all the 3 533 583 patients with HF, 774 887 had AKI, with a pooled incidence of 33% [95% confidence interval (CI): 32–35%]. The incidence rate of AKI in acute HF and chronic HF was 36% (95% CI: 31–40%) and 30% (95% CI: 24–35%), respectively. Eleven studies found that AKI patients had higher in‐hospital mortality than non‐AKI patients [risk ratio (RR): 3.65; 95% CI: 3.04–4.39, P 1.0 mg/dL, index estimated glomerular filtration rate 24 mg/dL, intravenous dobutamine, and serum albumin were predictor factors for HF patients with AKI (P