Impact of Worsening Renal Function During Hospital Admission on Resource Utilization in Patients With Heart Failure

Herout, Peter; Harshaw, Qing; Phatak, Hemant; Saka, G; McNeill, A J; Wormser, David; Sazonov, Vasilisa; DeSagun, Robert; Shirani, Jamshid

doi:10.1016/j.amjcard.2010.06.026

Cited by 19 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Potentially important components of a multimarker approach may include markers of renal impairment -a highly prevalent dysfunction in HF patients which is integral to disease progression [38,39]. While not nearly as well studied as their natriuretic peptide counterparts, markers of renal dysfunction or worsening renal failure have consistently been demonstrated to predict risk of poor clinical and economic outcomes in AHF patients [40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Association between cardiac, renal, and hepatic biomarkers and outcomes in patients with acute heart failure

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Association between cardiac, renal, and hepatic biomarkers and outcomes in patients with acute heart failure

et al. 2016

View full text Add to dashboard Cite

show abstract

“…All‐cause mortality was analyzed by short‐term (3‐month) and long‐term (1‐year) events. Despite the absence of expert consensus in terms of the definition of WRF, WRF was defined as an absolute increase in creatinine of 0.3 mg/dL or more, as per previous studies . In the present study, WRF was limited to those occurring during admission.…”

Section: Methodsmentioning

confidence: 96%

“…Despite the absence of expert consensus in terms of the definition of WRF, WRF was defined as an absolute increase in creatinine of 0.3 mg/dL or more, as per previous studies. 13 In the present study, WRF was limited to those occurring during admission. Transient WRF was defined as a recovery of creatinine level at discharge, by more than 0.3 mg/dL compared with the peak level during admission.…”

Section: Study End Points and Definitionsmentioning

confidence: 93%

Predictors and Prognostic Value of Worsening Renal Function During Admission in HFpEF Versus HFrEF: Data From the KorAHF (Korean Acute Heart Failure) Registry

Kang

Park

Cho

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundWorsening renal function (WRF) is associated with adverse outcomes in patients with heart failure. We investigated the predictors and prognostic value of WRF during admission, in patients with preserved ejection fraction (HFpEF) versus those with reduced ejection fraction (HFrEF).Methods and ResultsA total of 5625 patients were enrolled in the KorAHF (Korean Acute Heart Failure) registry. WRF was defined as an absolute increase in creatinine of ≥0.3 mg/dL. Transient WRF was defined as recovery of creatinine at discharge, whereas persistent WRF was indicated by a nonrecovered creatinine level. HFpEF and HFrEF were defined as a left ventricle ejection fraction ≥50% and ≤40%, respectively. Among the total population, WRF occurred in 3101 patients (55.1%). By heart failure subgroup, WRF occurred more frequently in HFrEF (57.0% versus 51.3%; P<0.001 in HFrEF and HFpEF). Prevalence of WRF increased as creatinine clearance decreased in both heart failure subgroups. Among various predictors of WRF, chronic renal failure was the strongest predictor. WRF was an independent predictor of adverse in‐hospital outcomes (HFrEF: odds ratio; 2.75; 95% confidence interval, 1.50–5.02; P=0.001; HFpEF: odds ratio, 9.48; 95% confidence interval, 1.19–75.89; P=0.034) and 1‐year mortality (HFrEF: hazard ratio, 1.41; 95% confidence interval, 1.12–1.78; P=0.004 versus HFpEF: hazard ratio, 1.72; 95% confidence interval, 1.23–2.42; P=0.002). Transient WRF was a risk factor for 1‐year mortality, whereas persistent WRF had no additive risk compared to transient WRF.ConclusionsIn patients with acute heart failure patients, WRF is an independent predictor of adverse in‐hospital and follow‐up outcomes in both HFrEF and HFpEF, though with a different effect size.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT01389843.

show abstract

“…Worsening renal function during hospitalization was found to be strongly related to a poorer outcome as well, independent of baseline renal function 2–9. Moreover, the occurrence of WRF during HF‐related hospitalization is associated with higher hospitalization costs and longer hospital stay 8. Early identification of patients at risk of WRF is therefore clinically important.…”

Section: Introductionmentioning

confidence: 99%

Early drop in systolic blood pressure and worsening renal function in acute heart failure: renal results of Pre‐RELAX‐AHF

Voors

Davison

Felker

et al. 2011

European J of Heart Fail

102

View full text Add to dashboard Cite

AimsWe aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and resultsThe Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of ≥0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30%). Patients with WRF were older (73.5 + 9.4 vs. 69.1 + 10.6 years; P ¼ 0.003), had a higher baseline SBP (147.3 + 19.9 vs. 140.8 + 16.7 mmHg; P ¼ 0.01), and had a greater early drop in SBP (37.9 + 16.0 vs. 31.4 + 12.2 mmHg; P ¼ 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P ¼ 0.01), and Day 180 (P ¼ 0.003) mortality. ConclusionsWorsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP. Trial registration clinicaltrials.gov identifier NCT00520806.--

show abstract

Impact of Worsening Renal Function During Hospital Admission on Resource Utilization in Patients With Heart Failure

Cited by 19 publications

References 23 publications

Association between cardiac, renal, and hepatic biomarkers and outcomes in patients with acute heart failure

Association between cardiac, renal, and hepatic biomarkers and outcomes in patients with acute heart failure

Predictors and Prognostic Value of Worsening Renal Function During Admission in HFpEF Versus HFrEF: Data From the KorAHF (Korean Acute Heart Failure) Registry

Early drop in systolic blood pressure and worsening renal function in acute heart failure: renal results of Pre‐RELAX‐AHF

Contact Info

Product

Resources

About