Worsening renal function in patients hospitalised for acute heart failure: clinical implications and prognostic significance.
Eur J Heart Fail
; 10(2): 188-95, 2008 Feb.
Article
em En
| MEDLINE
| ID: mdl-18279773
ABSTRACT
BACKGROUND:
Renal function is a powerful prognostic variable in patients with heart failure (HF). Hospitalisations for acute HF (AHF) may be associated with further worsening of renal function (WRF). METHODS ANDRESULTS:
We analysed the clinical significance of WRF in 318 consecutive patients admitted at our institute for AHF. WRF was defined as the occurrence, at any time during the hospitalisation, of both a > or =25% and a > or =0.3 mg/dL increase in serum creatinine (s-Cr) from admission (WRF-Abs-%).RESULTS:
Patients were followed for 480+/-363 days. Fifty-three patients (17%) died and 132 (41%) were rehospitalised for HF. WRF-Abs-% occurred in 107 (34%) patients. At multivariable survival analysis, WRF-Abs-% was an independent predictor of death or HF rehospitalisation (adjusted HR, 1.47; 95%CI, 1.13-1.81; p=0.024). The independent predictors of WRF-Abs-%, evaluated using multivariable logistic regression, were history of chronic kidney disease (p=0.002), LV ejection fraction (p=0.012), furosemide daily dose (p=0.03) and NYHA class (p=0.05) on admission.CONCLUSION:
WRF is a frequent finding in patients hospitalised for AHF and is associated with a poor prognosis. Severity of HF and daily furosemide dose are the most important predictors of the occurrence of WRF.
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Base de dados:
MEDLINE
Assunto principal:
Insuficiência Cardíaca
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Rim
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article