The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction

Dries, Daniel L.; Exner, Derek V.; Domanski, Michael J.; Greenberg, Barry; Stevenson, Lynne Warner

doi:10.1016/s0735-1097(99)00608-7

Cited by 775 publications

(519 citation statements)

References 11 publications

Supporting

Mentioning

464

Contrasting

Unclassified

Order By: Relevance

“…Additionally, the increased risk of bleeding may be due to platelet dysfunction, prolonged bleeding time, and small vessel disease associated with CKD 27, 28. Overall, CKD may be associated with adverse outcomes in HF, as it is a marker of more severe HF, greater symptom burden, and/or coexistent disease 1, 2, 29. The poorer survival in patients with CKD and HF may also reflect the reduced likelihood of being prescribed evidence‐based therapies,29, 30 as CKD is often viewed as a contraindication to some therapies,2, 29 including thromboprophylactic therapies 31.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, CKD may be associated with adverse outcomes in HF, as it is a marker of more severe HF, greater symptom burden, and/or coexistent disease 1, 2, 29. The poorer survival in patients with CKD and HF may also reflect the reduced likelihood of being prescribed evidence‐based therapies,29, 30 as CKD is often viewed as a contraindication to some therapies,2, 29 including thromboprophylactic therapies 31. This is correspondingly reflected in randomized trials testing the efficacy and safety of therapies, where patients with CKD are often excluded, resulting in clinicians being challenged in how to choose the optimal treatment for these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Heart failure (HF) and chronic kidney disease (CKD) often coexist 1, 2, 3. Among HF patients with concomitant CKD, mortality and morbidity are high 4, 5.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk of stroke and bleeding in patients with heart failure and chronic kidney disease: a nationwide cohort study

et al. 2018

View full text Add to dashboard Cite

AimsThe aim of this study was to assess the prognostic value of chronic kidney disease (CKD) in relation to ischaemic stroke, intracranial haemorrhage, major bleeding, and all‐cause death in heart failure patients without atrial fibrillation.Methods and resultsIn this observational cohort study, heart failure patients without atrial fibrillation were identified using Danish nationwide registries. Risk of stroke, major haemorrhage, and death were calculated after 1 and 5 years to compare patients with and without CKD, ±dialysis [dialysis: CKD with renal replacement therapy (CKD‐RRT); no dialysis: CKD‐no RRT]. A total of 43 199 heart failure patients were included, among which 0.8% had CKD‐RRT and 5.9% had CKD‐no RRT. When compared with heart failure patients without CKD, both CKD‐RRT and CKD‐no RRT were associated with a higher 5 year rate of major bleeding (CKD‐RRT: adjusted hazard ratio (aHR): 2.91, 95% confidence interval (CI): 2.29 to 3.70; CKD‐no RRT: aHR: 1.28, 95% CI: 1.13 to 1.45) and all‐cause death (CKD‐RRT: aHR: 2.40, 95% CI: 2.07 to 2.77; CKD‐no RRT: aHR: 1.63, 95% CI: 1.55 to 1.73). For the endpoints of ischaemic stroke and intracranial bleeding, only CKD‐no RRT was associated with significantly higher 5 year rates (ischaemic stroke: aHR: 1.31, 95% CI: 1.13 to 1.52; intracranial haemorrhage: aHR: 1.66, 95% CI: 1.04 to 2.65).ConclusionsCompared with patients without CKD, among incident heart failure patients without atrial fibrillation, CKD both with and without dialysis was associated with a higher rate of major bleeding and all‐cause death. Only CKD‐no RRT was associated with a higher rate of ischaemic stroke and intracranial bleeding.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of stroke and bleeding in patients with heart failure and chronic kidney disease: a nationwide cohort study

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Chronic renal dysfunction has a negative effect on cardiac function and chronic kidney disease (CKD) is an important predictor of adverse outcome and increased morbidity in patients with chronic heart failure (CHF). [14][15][16][17] A stage classification for CKD has been proposed for assessing the degree of severity of renal dysfunction, and recent evidence indicates that a moderate decrease in glomerular filtration rate (GFR) to <60 ml/min/1.73 m2 of body surface area is associated with an adverse outcome in CHF patients. [14][15][16] Diastolic dysfunction is frequently observed in CHF patients with or without CKD [18] and (tissue Doppler imaging) TDI has improved assessment of this condition.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17] A stage classification for CKD has been proposed for assessing the degree of severity of renal dysfunction, and recent evidence indicates that a moderate decrease in glomerular filtration rate (GFR) to <60 ml/min/1.73 m2 of body surface area is associated with an adverse outcome in CHF patients. [14][15][16] Diastolic dysfunction is frequently observed in CHF patients with or without CKD [18] and (tissue Doppler imaging) TDI has improved assessment of this condition. [19] Left ventricular diastolic dysfunction affects morbidity and mortality in CHF patients with CKD, and echocardiography may provide additional diagnostic data on ventricular function.…”

Section: Introductionmentioning

confidence: 99%

Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India

Sidmal¹,

Hp²,

Kc³

2015

Int Jour of Biomed Res

View full text Add to dashboard Cite

Background: The chronic kidney disease (CKD) is a major risk factor for coronary artery disease (CAD) and left ventricle systolic dysfunction. Left ventricular (LV) diastolic dysfunction in CKD patients frequently leads to the development of congestive heart failure. The interaction between diastolic dysfunction (DD) and renal function in subjects with preserved systolic function is not well defined. Objective: Our aim was to investigate whether renal insufficiency (RI) is associated with DD among patients with left ventricular ejection fraction (LVEF) > 50%, and to investigate whether there is a correlation between CKD and DD severity. Methods: Eighty four CKD patients, aged 35-79 were examined by standard echocardiography. Subjects were divided into 4 groups depending on their estimated glomerular filtration rate (eGFR: ml/min/BSA) as follows: group 1 (60-89 ml/min/BSA), group 2 (30-59 ml/min/BSA), group 3 (15-29 ml/min/BSA) and group 4 (less than 15 ml/min/BSA), between 1/2/2014 and 30/4/2015. Glomerular filtration rate (GFR) was estimated using the MDRD formula. Patients with impaired relaxation (grade I) were compared to those with pseudonormal (grade II) or restrictive (grade III-IV) DD. Results: Among 84 patients, 23 had GFR 60-89 ml/min/BSA; 16 had GFR 30-59 ml/min/BSA; and 19 had GFR 15-30 ml/min/BSA and 26 had GFR <15 ml/min/BSA. There was a significant correlation between worsening GFR and degree of diastolic dysfunction (DD) assessed by echo. Overall, 40.4% of the participants were female, 22 (26.1 %) had grade I, & 10 (11.9 %) had grade II, 16 (19%) had grade III and 36 (42.8%) had grade IV diastolic dysfunction. Almost all patients had some degree of diastolic dysfunction. With worsening of renal function, there was worsening of diastolic dysfunction seen. In patients with end stage renal disease many had grade IV diastolic dysfunction as compared to patients with early CKD. Grade I and II DD was commonly seen in group 1 and 2. But grade III and IV DD was commonly seen in group 3 and 4. Conclusion: Worsening renal function was associated with greater degree of diastolic dysfunction and adverse clinical outcomes. Our Study indicated a clear and independent association between RI and DD. The severity of RI also tends to correlate with the severity of DD. And that LV diastolic dysfunction was observed even in patients with early stages of chronic kidney dysfunction.

show abstract

High-Normal Serum Creatinine Concentration Is a Predictor of Cardiovascular Risk in Essential Hypertension

Schillaci¹,

Reboldi²,

Verdecchia³

2001

Arch Intern Med

155

View full text Add to dashboard Cite

show abstract

The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction

Cited by 775 publications

References 11 publications

Risk of stroke and bleeding in patients with heart failure and chronic kidney disease: a nationwide cohort study

Risk of stroke and bleeding in patients with heart failure and chronic kidney disease: a nationwide cohort study

Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India

High-Normal Serum Creatinine Concentration Is a Predictor of Cardiovascular Risk in Essential Hypertension

Contact Info

Product

Resources

About