Worsening Renal Function in Patients Admitted With Acute Decompensated Heart Failure: Incidence, Risk Factors and Prognostic Implications

Belziti, César; Bagnati, Rodrigo; Ledesma, Paola; Vulcano, Norberto; Fernández, Sandra

doi:10.1016/s1885-5857(10)70062-1

Cited by 30 publications

(48 citation statements)

References 29 publications

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“…[21][22][23][24] All study patients, except patient #3, did not show changes in serum creatinine, BUN, and eGFR levels during TLV treatment. In some studies, favorable effects for renal function of tolvaptan, unlike loop diuretics, have been reported in both in vitro and in vivo investigations.…”

Section: Discussionmentioning

confidence: 83%

Successful Treatment of Congestive Heart Failure Due to Severe Aortic Valve Stenosis With Low Dose Tolvaptan in Elderly Patients

et al. 2017

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SummaryMedical therapy for severe aortic valve stenosis (AS) is necessary for inoperable patients due to comorbid conditions. Tolvaptan (TLV), unlike other diuretics, resulted in modest changes in filling pressures associated with an increase in urine output, suggesting that TLV improves congestive heart failure (CHF) due to severe AS without hemodynamic instability.We retrospectively investigated 14 consecutive patients ≥ 80 years of age admitted due to decompensated CHF with severe AS at Juntendo University Hospital from April 2014 to November 2015. Seven of the 14 patients were treated with TLV. We examined the safety and efficacy of TLV treatment for severe AS.Mean age was 90.0 ± 6.3 years and mean aortic valve area was 0.57 ± 0.22 cm 2. Urine volume at day 1 of TLV treatment was increased and urine osmolality significantly decreased at day 1 of TLV treatment (all P < 0.05). New York Heart Association classification and brain natriuretic peptide levels significantly improved 1 week after treatment and at discharge (all P < 0.05) whereas brain natriuretic peptide levels did not improve in the patients without TLV. Severe adverse events did not occur during TLV treatment. During the first 3 days, blood pressure and heart rate were relatively stable. TLV treatment did not affect serum creatinine, blood urea nitrogen, or the estimated glomerular filtration rate.In elderly patients with severe AS, TLV treatment improved CHF without hemodynamic instability. Further prospective studies are needed to assess the safety and efficacy of TLV in decompensated heart failure due to severe AS. (Int Heart J 2017; 58: 378-384)

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Section: Discussionmentioning

confidence: 83%

Successful Treatment of Congestive Heart Failure Due to Severe Aortic Valve Stenosis With Low Dose Tolvaptan in Elderly Patients

et al. 2017

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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%

“…In ADHF, AKI is associated with increased risk for both short-and long-term all-cause and cardiovascular mortality [5,6,10,12,17,[22][23][24][25]. In addition, data suggest there is a biological gradient between AKI severity and mortality [26].…”

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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“…Worsening renal function, defined as a change in serum creatinine ≥ 0.3 mg/mL during hospitalization, has been reported to be associated with an increased risk for long-term all cause/cardiovascular mortality and morbidity in AHF patients. 2,[21][22][23][24] In fact, in a retrospective study of 200,063 hospitalized AHF patients, Kociol, et al found that 17.8% developed worsening renal function, with 64.5% of these patients being readmitted and 35.4% dying within 1 year. After adjustment for patient characteristics, worsening renal function was independently associated with long-term mortality (HR 1.12, 95% CI: 1.04-1.20).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Prognostic Impact After Acute Kidney Injury in Patients With Acute Heart Failure

et al. 2012

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SummaryThe relationship between the short-term prognosis of acute heart failure (AHF) and acute kidney injury (AKI) using the risk, injury, failure, and end stage (RIFLE) criteria has already been reported, however, the relationship between the long-term prognosis and AKI has not. We investigated the relationship between the long-term prognosis after discharge and AKI using the RIFLE criteria. Five hundred patients with AHF admitted to our intensive care unit were analyzed. Patients were assigned to a no AKI (n = 156), Class R (risk; n = 201), Class I (injury; n = 73), or Class F (failure; n = 70) using the most severe RIFLE classifications during hospitalization. We evaluated the relationships between the RIFLE classifications and any-cause death, and HF events including death and readmission for HF within 1 year. A multivariate logistic regression model found that Class I (P = 0.013, OR: 2.768; 95% CI: 1.236-6.199) and Class F (P < 0.001, OR: 7.920; 95% CI: 3.497-17.938) were independently associated with any-cause death, and Class F was associated with HF events (P = 0.001, OR: 3.486; 95% CI: 1.669-7

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Worsening Renal Function in Patients Admitted With Acute Decompensated Heart Failure: Incidence, Risk Factors and Prognostic Implications

Cited by 30 publications

References 29 publications

Successful Treatment of Congestive Heart Failure Due to Severe Aortic Valve Stenosis With Low Dose Tolvaptan in Elderly Patients

Successful Treatment of Congestive Heart Failure Due to Severe Aortic Valve Stenosis With Low Dose Tolvaptan in Elderly Patients

Epidemiology and outcome of the cardio-renal syndrome

Long-Term Prognostic Impact After Acute Kidney Injury in Patients With Acute Heart Failure

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