Albuminuria in chronic heart failure: prevalence and prognostic importance

Jackson, Colette E.; Solomon, Scott D.; Gerstein, Hertzel C.; Zetterstrand, Sofia; Olofsson, Bertil; Michelson, Eric L.; Granger, Christopher B.; Swedberg, Karl; Pfeffer, Marc A.; Yusuf, Salim; McMurray, John J.V.

doi:10.1016/s0140-6736(09)61378-7

Cited by 257 publications

(215 citation statements)

References 28 publications

Supporting

Mentioning

185

Contrasting

Unclassified

Order By: Relevance

“…14 Furthermore, measures of albuminuria were available in 30% of North American patients, of whom 58% had normal values. 15 Thus, it may be difficult to generalize data from the CHARM or the EFFECT studies regarding the effect of recurrent HF hospitalizations on patients with lower GFR and/or albuminuria.…”

Section: Discussionmentioning

confidence: 99%

ESRD and Death after Heart Failure in CKD

Sud¹,

Tangri

Pintilie

et al. 2015

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

CKD is a risk factor for heart failure, but there is no data on the risk of ESRD and death after recurrent hospitalizations for heart failure. We sought to determine how interim heart failure hospitalizations modify the subsequent risk of ESRD or death before ESRD in patients with CKD. We retrospectively identified 2887 patients with a GFR between 15 and 60 ml/min per 1.73 m 2 referred between January of 2001 andDecember of 2008 to a nephrology clinic in Toronto, Canada. We ascertained interim first, second, and third heart failure hospitalizations as well as ESRD and death before ESRD outcomes from administrative data. Over a median follow-up time of 3.01 (interquartile range=1.56-4.99) years, interim heart failure hospitalizations occurred in 359 (12%) patients, whereas 234 (8%) patients developed ESRD, and 499 (17%) patients died before ESRD. Compared with no heart failure hospitalizations, one, two, or three or more heart failure hospitalizations increased the adjusted hazard ratio of ESRD from 4.89 (95% confidence interval [95% CI], 3.21 to 7.44) to 10.27 (95% CI, 5.54 to 19.04) to 14.16 (95% CI, 8.07 to 24.83), respectively, and the adjusted hazard ratio death before ESRD from 3.30 (95% CI, 2.55 to 4.27) to 4.20 (95% CI, 2.82 to 6.25) to 6.87 (95% CI, 4.96 to 9.51), respectively. We conclude that recurrent interim heart failure is associated with a stepwise increase in the risk of ESRD and death before ESRD in patients with CKD.

show abstract

Section: Discussionmentioning

confidence: 99%

ESRD and Death after Heart Failure in CKD

Sud¹,

Tangri

Pintilie

et al. 2015

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…However, the MDRD studyderived data on the protective effect of treatment in patients with proteinuria were observational in nature. Furthermore, the prognostic importance of urinary protein excretion is still under debate because, although it is well established that absolute urinary protein values represent a risk factor for either renal or CV outcomes [34,35], it has not been established whether this is also the case for treatment-induced changes in these values. In a number of studies on diabetic or nondiabetic individuals, increased levels of proteinuria during treatment were accompanied by a significantly greater risk of CV events and renal deterioration than were stable or decreased levels [36][37][38].…”

Section: Introductionmentioning

confidence: 99%

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Mancia

2018

Diabetologia

View full text Add to dashboard Cite

When associated with high blood pressure, type 2 diabetes mellitus is characterised by a high risk of adverse cardiovascular (CV) and renal outcomes. However, both can be effectively reduced by antihypertensive treatment. Current guidelines on the treatment of hypertension emphasize the need to effectively treat high blood pressure in diabetic individuals, but their recommendations differ in terms of the optimal target blood pressure value to aim for in order to maximise CV and renal protection. In some guidelines the recommended target blood pressure values are <140/90 mmHg (systolic/diastolic), whereas in others, blood pressure values close or even less than 130/80 mmHg are recommended. This paper will discuss the evidence for and against a conservative or more aggressive blood pressure target for treated diabetic hypertensive individuals based on the evidence provided by randomised trials, trial meta-analyses and large observational studies. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90 mmHg, and that values approaching 130/80 mmHg should be recommended. However, evidence in favour of even lower systolic values, i.e. <130 mmHg, is limited and is definitively against a reduction to <120 mmHg.

show abstract

“…In general, CHF patients with microalbuminuria have poorer prognosis regardless of DM, hypertension or renal function, given that microalbuminuria is likely to be associated with inflammation and activation of the RAS and sympathetic nervous system. 24 This could explain why, in the present study, IHD patients with both DM and nephropathy had more cardiovascular events. In contrast, in the absence of nephropathy, DM patients had a similar prognosis to non-DM patients.…”

Section: Dm In Chf Patientsmentioning

confidence: 52%

Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease　– With Special Reference to Nephropathy –

Miura

Sakata

Miyata

et al. 2015

Circ J

View full text Add to dashboard Cite

Albuminuria in chronic heart failure: prevalence and prognostic importance

Cited by 257 publications

References 28 publications

ESRD and Death after Heart Failure in CKD

ESRD and Death after Heart Failure in CKD

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease　– With Special Reference to Nephropathy –

Contact Info

Product

Resources

About

Albuminuria in chronic heart failure: prevalence and prognostic importance

Cited by 257 publications

References 28 publications

ESRD and Death after Heart Failure in CKD

ESRD and Death after Heart Failure in CKD

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease – With Special Reference to Nephropathy –

Contact Info

Product

Resources

About

Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease　– With Special Reference to Nephropathy –