Document Detail

Worsening renal function in patients hospitalised for acute heart failure: clinical implications and prognostic significance.
MedLine Citation:
PMID:  18279773     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Renal function is a powerful prognostic variable in patients with heart failure (HF). Hospitalisations for acute HF (AHF) may be associated with further worsening of renal function (WRF).
METHODS AND RESULTS: We analysed the clinical significance of WRF in 318 consecutive patients admitted at our institute for AHF. WRF was defined as the occurrence, at any time during the hospitalisation, of both a > or =25% and a > or =0.3 mg/dL increase in serum creatinine (s-Cr) from admission (WRF-Abs-%).
RESULTS: Patients were followed for 480+/-363 days. Fifty-three patients (17%) died and 132 (41%) were rehospitalised for HF. WRF-Abs-% occurred in 107 (34%) patients. At multivariable survival analysis, WRF-Abs-% was an independent predictor of death or HF rehospitalisation (adjusted HR, 1.47; 95%CI, 1.13-1.81; p=0.024). The independent predictors of WRF-Abs-%, evaluated using multivariable logistic regression, were history of chronic kidney disease (p=0.002), LV ejection fraction (p=0.012), furosemide daily dose (p=0.03) and NYHA class (p=0.05) on admission.
CONCLUSION: WRF is a frequent finding in patients hospitalised for AHF and is associated with a poor prognosis. Severity of HF and daily furosemide dose are the most important predictors of the occurrence of WRF.
Marco Metra; Savina Nodari; Giovanni Parrinello; Tania Bordonali; Silvia Bugatti; Rossella Danesi; Benedetta Fontanella; Carlo Lombardi; Patrizia Milani; Giulia Verzura; Gadi Cotter; Howard Dittrich; Barry M Massie; Livio Dei Cas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of heart failure     Volume:  10     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-18     Completed Date:  2008-05-28     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  188-95     Citation Subset:  IM    
Section on Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Brescia, Italy.
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MeSH Terms
Creatinine / blood
Diuretics / administration & dosage
Furosemide / administration & dosage
Heart Failure / mortality,  physiopathology*
Kidney / physiopathology*
Middle Aged
Prospective Studies
Survival Analysis
Reg. No./Substance:
0/Diuretics; 54-31-9/Furosemide; 60-27-5/Creatinine

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