Renal function and long-term survival after hospital discharge in heart failure with preserved ejection fraction

Ruşinaru, Dan; Buiciuc, Otilia; Houpe, D.; Tribouilloy, Christophe

doi:10.1016/j.ijcard.2009.09.529

Cited by 47 publications

(31 citation statements)

References 25 publications

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“…However, we did adjust for anemia in the multivariable analyses and showed in a cohort of 754 patients followed at a specialized HF clinic (in whom we had hemoglobin data) that renal insufficiency is an independent prognostic factor, even after adjusting for hemoglobin values. 7 In the same vein, we do not have data on other renal function metrics, such as albuminuria, 22 rate of change in eGFR, 28 or cystatin C levels, 21,29 which appear to be prognostically important in patients regardless of eGFR level; however, this mimics clinical practice in that the majority of patients with HF are managed without access to cystatin C levels. Finally, we acknowledge that there is variability between laboratories in measurement of SCr levels before the introduction of isotope-dilution mass spectrometry standardization in the mid-2000s; however, this variability was shown to predominantly introduce error at higher eGFR levels (ie, Ͼ60 mL/min), which were not the focus of the present study.…”

Section: Discussionmentioning

confidence: 96%

Renal Dysfunction in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction

McAlister

Ezekowitz²,

Tarantini³

et al. 2012

Circ: Heart Failure

168

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Section: Discussionmentioning

confidence: 96%

Renal Dysfunction in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction

McAlister

Ezekowitz²,

Tarantini³

et al. 2012

Circ: Heart Failure

168

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“…30, 117, 118 Beyond baseline impairment, worsening renal function during HFpEF hospital admission predicts higher mortality at 6-months, with a 7-year survival of only 9%. 118 Albuminuria is an established independent risk factor of mortality in the general population, reflecting glomerular injury, activation of the RAAS system, and systemic inflammation, and has been reported in a third of HFpEF patients. 119 During a 2.5 year follow up period, those with albuminuria at all strata of estimated glomerular filtration rate had higher rates of cardiovascular and non-cardiovascular death 119 .…”

Section: Mechanisms Of Diseasementioning

confidence: 99%

Heart Failure With Preserved Ejection Fraction

Sharma

Kass

2014

Circulation Research

423

227

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The clinical syndrome comprised of heart failure symptoms but with a left ventricular ejection fraction that is not diminished, e.g. heart failure with a preserved ejection fraction (HFpEF), is increasingly the predominant form of HF in the developed world, and soon to reach epidemic proportions. It remains among the most challenging of clinical syndromes for the practicing clinician and scientist alike, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common co-morbidities. Importantly, its morbidity and mortality is on par with heart failure and a reduced ejection fraction, and as the list of failed treatments continues to grow, HFpEF clearly represents a major unmet medical need. The field is greatly in need of a more unified approach to its definition and view of the syndrome that engages integrative and reserve pathophysiology beyond that related to the heart alone. We need to reflect on prior treatment failures and the message this is providing, and re-direct our approaches likely with a paradigm shift in how the disease is viewed. Success will require interactions between clinicians, translational researchers, and basic physiologists. Here, we review recent translational and clinical research into HFpEF, give perspectives on its evolving demographics and epidemiology, the role of multi-organ deficiencies, potential mechanisms that involve the heart and other organs, clinical trials, and future directions.

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“…An important risk factor also includes baseline kidney function and presence of CKD [17,18]. Aronson et al [19] recently showed persistent WRF after admission for ADHF was more likely in those with worse baseline kidney function.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and outcome of the cardio-renal syndrome

Cruz

Gheorghiade

Palazuolli³

et al. 2010

Heart Fail Rev

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Cardiac and kidney disease are common, increasingly encountered and often co-exist. Recently, the Acute Dialysis Quality Initiative (ADQI) Working Group convened a consensus conference to develop a classification scheme for the CRS and for five discrete subtypes. These CRS subtypes likely share pathophysiologic mechanisms, however, also have distinguishing clinical features, in terms of precipitating events, risk identification, natural history and outcomes. Knowledge of the epidemiology of heart-kidney interaction stratified by the proposed CRS subtypes is increasingly important for understanding the overall burden of disease for each CRS subtype, along with associated morbidity, mortality and health resource utilization. Likewise, an understanding of the epidemiology of CRS is necessary for characterizing whether there exists important knowledge gaps and to aid the in the design of clinical studies. In the most recent European and American guidelines for heart failure management, acute kidney injury and dysfunction were considered an index of poor prognosis. Paradoxically, however, in many randomized trials of interventions for patients with heart failure, those with kidney injury or dysfunction are often excluded. This review will provide a summary of the epidemiology of the cardio-renal syndrome and its subtypes.

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Renal function and long-term survival after hospital discharge in heart failure with preserved ejection fraction

Cited by 47 publications

References 25 publications

Renal Dysfunction in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction

Renal Dysfunction in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction

Heart Failure With Preserved Ejection Fraction

Epidemiology and outcome of the cardio-renal syndrome

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