Effect of renal function on prognosis in chronic heart failure.

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Tytuł:: Effect of renal function on prognosis in chronic heart failure.
Autorzy:: Löffler AI; Department of Cardiovascular Medicine, University of Wisconsin, Madison, Wisconsin. Electronic address: .
Cappola TP; Department of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Fang J; Department of Cardiology, Case Western Reserve University, Cleveland, Ohio.
Hetzel SJ; Department of Cardiovascular Medicine, University of Wisconsin, Madison, Wisconsin.
Kadlec A; Department of Cardiovascular Medicine, University of Wisconsin, Madison, Wisconsin.
Astor B; Department of Cardiovascular Medicine, University of Wisconsin, Madison, Wisconsin.
Sweitzer NK; Department of Cardiovascular Medicine, University of Wisconsin, Madison, Wisconsin.
Źródło:: The American journal of cardiology [Am J Cardiol] 2015 Jan 01; Vol. 115 (1), pp. 62-8. Date of Electronic Publication: 2014 Oct 23.
Typ publikacji:: Journal Article; Multicenter Study; Observational Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: New York, NY : Excerpta Medica
MeSH Terms:: Glomerular Filtration Rate/*physiology
Heart Failure/*physiopathology
Renal Insufficiency/*physiopathology
Risk Assessment/*methods
Female ; Follow-Up Studies ; Heart Failure/complications ; Heart Failure/mortality ; Humans ; Incidence ; Male ; Middle Aged ; Pennsylvania/epidemiology ; Prognosis ; Prospective Studies ; Renal Insufficiency/epidemiology ; Renal Insufficiency/etiology ; Risk Factors ; Survival Rate/trends ; Time Factors
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Grant Information:: R01 HL088577 United States HL NHLBI NIH HHS; R01HL088577 United States HL NHLBI NIH HHS
Entry Date(s):: Date Created: 20141204 Date Completed: 20150224 Latest Revision: 20181113
Update Code:: 20240104
PubMed Central ID:: PMC4262654
DOI:: 10.1016/j.amjcard.2014.09.055
PMID:: 25465925
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Renal dysfunction (RD) is associated with increased mortality in heart failure (HF). The aim of this study was to identify whether worsened or improved renal function during mid-term follow-up is associated with worsened outcomes in patients with chronic HF. A total of 892 participants from a multicenter cohort study of chronic HF were followed over 3.1 ± 1.9 years of enrollment. Worsened and improved renal functions were tested with multivariate models as independent predictors of HF hospitalization and mortality. Although 12% of subjects experienced a ≥25% decrease in estimated glomerular filtration rate (eGFR), 17% experienced a ≥25% increase in eGFR, and there was stability of kidney function observed in the cohort as a whole. The quartile with the worst RD at any point in time had increased risk of HF hospitalization and mortality. Worsened eGFR was associated with HF outcomes in the unadjusted (hazard ratio = 1.71, 95% confidence interval 1.04 to 2.81, p = 0.035), but not the adjusted analysis. Improvement in eGFR was not associated with outcome (p = 0.453). In chronic HF, the severity of RD predicts risk of poor outcome better than changes in renal function during mid-term follow-up. This suggests that in patients with appropriately treated chronic HF, worsening renal function in itself does not yield useful prognostic information and may not reflect poor outcome.
(Copyright © 2015 Elsevier Inc. All rights reserved.)

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