Body volume is the major determinant of worsening renal function in acutely decompensated heart failure with reduced left ventricular ejection fraction
AimsLittle is known about the relative importance of body volume and haemodynamic parameters in the development of worsening of renal function in acutely decompensated heart failure (ADHF). To study the relationship between haemodynamic parameters, body water content and worsening of renal function...
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| Veröffentlicht in: | Postgraduate medical journal 2022-05, Vol.98 (1159), p.333-340 |
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| creator | Ho, Mei Han Huang, Duo Ho, Chi-Wai Zuo, Ming-Liang Luo, An-Guo Cheung, Emmanuel Zhou, Mi Cheng, Yangyang Liu, Mingya Yiu, Kai-Hang Lau, Chu Pak Yeung, Pauline Yue, Wen Sheng Yin, Li-Xue Tse, Hung Fat Jiang, Wei Lei, Zhen Li, Xin-Li Cowie, M Siu, Chung Wah |
| description | AimsLittle is known about the relative importance of body volume and haemodynamic parameters in the development of worsening of renal function in acutely decompensated heart failure (ADHF). To study the relationship between haemodynamic parameters, body water content and worsening of renal function in patients with heart failure with reduced ejection fraction (HFrEF) hospitalised for ADHF.Methods and resultsThis prospective observational study involved 51 consecutive patients with HFrEF (age: 73±14 years, male: 60%, left ventricular ejection fraction: 33.3%±9.9%) hospitalised for ADHF. Echocardiographic-determined haemodynamic parameters and body volume determined using a bioelectric impedance analyser were serially obtained. All patients received intravenous furosemide 160 mg/day for 3 days. There was a mean weight loss of 3.95±2.82 kg (p |
| doi_str_mv | 10.1136/postgradmedj-2020-139023 |
| format | Article |
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To study the relationship between haemodynamic parameters, body water content and worsening of renal function in patients with heart failure with reduced ejection fraction (HFrEF) hospitalised for ADHF.Methods and resultsThis prospective observational study involved 51 consecutive patients with HFrEF (age: 73±14 years, male: 60%, left ventricular ejection fraction: 33.3%±9.9%) hospitalised for ADHF. Echocardiographic-determined haemodynamic parameters and body volume determined using a bioelectric impedance analyser were serially obtained. All patients received intravenous furosemide 160 mg/day for 3 days. There was a mean weight loss of 3.95±2.82 kg (p<0.01), and brain natriuretic peptide (BNP) reduced from 1380±901 pg/mL to 797±738 pg/mL (p<0.01). Nonetheless serum creatinine (SCr) increased from 134±46 μmol/L to 151±53 μmol/L (p<0.01), and 35% of patients developed worsening of renal function. The change in SCr was positively correlated with age (r=0.34, p=0.017); and negatively with the ratio of extracellular water to total body water, a parameter of body volume status (r=−0.58, p<0.001); E:E’ ratio (r=−0.36, p=0.01); right ventricular systolic pressure (r=−0.40, p=0.009); and BNP (r=−0.40, p=0.004). Counterintuitively, no correlation was observed between SCr and cardiac output, or total peripheral vascular resistance. Regression analysis revealed that normal body volume and lower BNP independently predicted worsening of renal function.ConclusionsNormal body volume and lower serum BNP on admission were associated with worsening of renal function in patients with HFrEF hospitalised for ADHF.</description><identifier>ISSN: 0032-5473</identifier><identifier>EISSN: 1469-0756</identifier><identifier>DOI: 10.1136/postgradmedj-2020-139023</identifier><identifier>PMID: 33593808</identifier><language>eng</language><publisher>England: The Fellowship of Postgraduate Medicine</publisher><subject>Acute coronary syndromes ; acute renal failure ; Aged ; Aged, 80 and over ; Beta blockers ; Blood pressure ; Body composition ; Body Size ; Cardiac arrhythmia ; Cardiovascular disease ; Creatinine ; Diabetes ; Drug dosages ; Ejection fraction ; Female ; Heart Failure ; Hemodynamics ; Humans ; Hypertension ; ischaemic heart disease ; Kidney - diagnostic imaging ; Kidney - physiology ; Male ; Middle Aged ; Mortality ; Natriuretic Peptide, Brain ; Original research ; Pacemakers ; Peptides ; Population ; Prognosis ; Stroke Volume ; Ventricular Function, Left</subject><ispartof>Postgraduate medical journal, 2022-05, Vol.98 (1159), p.333-340</ispartof><rights>Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-b377t-bcbf98e8562656c825a062f1a93aa972d7c5e1ad3f398ef207302714e7ab30f03</cites><orcidid>0000-0002-3526-8950 ; 0000-0002-2666-3086</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33593808$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ho, Mei Han</creatorcontrib><creatorcontrib>Huang, Duo</creatorcontrib><creatorcontrib>Ho, Chi-Wai</creatorcontrib><creatorcontrib>Zuo, Ming-Liang</creatorcontrib><creatorcontrib>Luo, An-Guo</creatorcontrib><creatorcontrib>Cheung, Emmanuel</creatorcontrib><creatorcontrib>Zhou, Mi</creatorcontrib><creatorcontrib>Cheng, Yangyang</creatorcontrib><creatorcontrib>Liu, Mingya</creatorcontrib><creatorcontrib>Yiu, Kai-Hang</creatorcontrib><creatorcontrib>Lau, Chu Pak</creatorcontrib><creatorcontrib>Yeung, Pauline</creatorcontrib><creatorcontrib>Yue, Wen Sheng</creatorcontrib><creatorcontrib>Yin, Li-Xue</creatorcontrib><creatorcontrib>Tse, Hung Fat</creatorcontrib><creatorcontrib>Jiang, Wei</creatorcontrib><creatorcontrib>Lei, Zhen</creatorcontrib><creatorcontrib>Li, Xin-Li</creatorcontrib><creatorcontrib>Cowie, M</creatorcontrib><creatorcontrib>Siu, Chung Wah</creatorcontrib><title>Body volume is the major determinant of worsening renal function in acutely decompensated heart failure with reduced left ventricular ejection fraction</title><title>Postgraduate medical journal</title><addtitle>Postgrad Med J</addtitle><addtitle>Postgrad Med J</addtitle><description>AimsLittle is known about the relative importance of body volume and haemodynamic parameters in the development of worsening of renal function in acutely decompensated heart failure (ADHF). To study the relationship between haemodynamic parameters, body water content and worsening of renal function in patients with heart failure with reduced ejection fraction (HFrEF) hospitalised for ADHF.Methods and resultsThis prospective observational study involved 51 consecutive patients with HFrEF (age: 73±14 years, male: 60%, left ventricular ejection fraction: 33.3%±9.9%) hospitalised for ADHF. Echocardiographic-determined haemodynamic parameters and body volume determined using a bioelectric impedance analyser were serially obtained. All patients received intravenous furosemide 160 mg/day for 3 days. There was a mean weight loss of 3.95±2.82 kg (p<0.01), and brain natriuretic peptide (BNP) reduced from 1380±901 pg/mL to 797±738 pg/mL (p<0.01). Nonetheless serum creatinine (SCr) increased from 134±46 μmol/L to 151±53 μmol/L (p<0.01), and 35% of patients developed worsening of renal function. The change in SCr was positively correlated with age (r=0.34, p=0.017); and negatively with the ratio of extracellular water to total body water, a parameter of body volume status (r=−0.58, p<0.001); E:E’ ratio (r=−0.36, p=0.01); right ventricular systolic pressure (r=−0.40, p=0.009); and BNP (r=−0.40, p=0.004). Counterintuitively, no correlation was observed between SCr and cardiac output, or total peripheral vascular resistance. Regression analysis revealed that normal body volume and lower BNP independently predicted worsening of renal function.ConclusionsNormal body volume and lower serum BNP on admission were associated with worsening of renal function in patients with HFrEF hospitalised for ADHF.</description><subject>Acute coronary syndromes</subject><subject>acute renal failure</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Beta blockers</subject><subject>Blood pressure</subject><subject>Body composition</subject><subject>Body Size</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Drug dosages</subject><subject>Ejection fraction</subject><subject>Female</subject><subject>Heart Failure</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypertension</subject><subject>ischaemic heart disease</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney - physiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Natriuretic Peptide, Brain</subject><subject>Original research</subject><subject>Pacemakers</subject><subject>Peptides</subject><subject>Population</subject><subject>Prognosis</subject><subject>Stroke Volume</subject><subject>Ventricular Function, Left</subject><issn>0032-5473</issn><issn>1469-0756</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqVkctu1DAUhi0EotPCKyBLbNik-BLHzhIqblIlNrCOHOe44yixB19azZPwunhIKYgNYmVL5_v-Y_lHCFNySSnvXh9CyjdRTytMc8MIIw3lPWH8EdrRtusbIkX3GO0I4awRreRn6DylmRDKZUufojPORc8VUTv0_W2Yjvg2LGUF7BLOe8CrnkPEE2SIq_PaZxwsvgsxgXf-BkfwesG2eJNd8Nh5rE3JsByrYsJ6AJ90hgnvQceMrXZLiYDvXN5XdSqmjhawGd-Cz9GZsuiIYYYtzUb98_IMPbF6SfD8_rxAX9-_-3L1sbn-_OHT1ZvrZuRS5mY0o-0VKNGxTnRGMaFJxyzVPde6l2ySRgDVE7e8YpYRyQmTtAWpR04s4Rfo1ZZ7iOFbgZSH1SUDy6I9hJIGJpgSREkiKvryL3QOJda_qFRdrpSg4kSpjTIxpBTBDofoVh2PAyXDqbzhz_KGU3nDVl5VX9wvKGMdPoi_2qoA34Bxnf8ntv1tPTz5n9oPyE2-hA</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Ho, Mei Han</creator><creator>Huang, Duo</creator><creator>Ho, Chi-Wai</creator><creator>Zuo, Ming-Liang</creator><creator>Luo, An-Guo</creator><creator>Cheung, Emmanuel</creator><creator>Zhou, Mi</creator><creator>Cheng, Yangyang</creator><creator>Liu, Mingya</creator><creator>Yiu, Kai-Hang</creator><creator>Lau, Chu Pak</creator><creator>Yeung, Pauline</creator><creator>Yue, Wen Sheng</creator><creator>Yin, Li-Xue</creator><creator>Tse, Hung Fat</creator><creator>Jiang, Wei</creator><creator>Lei, Zhen</creator><creator>Li, Xin-Li</creator><creator>Cowie, M</creator><creator>Siu, Chung Wah</creator><general>The Fellowship of Postgraduate Medicine</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3526-8950</orcidid><orcidid>https://orcid.org/0000-0002-2666-3086</orcidid></search><sort><creationdate>20220501</creationdate><title>Body volume is the major determinant of worsening renal function in acutely decompensated heart failure with reduced left ventricular ejection fraction</title><author>Ho, Mei Han ; Huang, Duo ; Ho, Chi-Wai ; Zuo, Ming-Liang ; Luo, An-Guo ; Cheung, Emmanuel ; Zhou, Mi ; Cheng, Yangyang ; Liu, Mingya ; Yiu, Kai-Hang ; Lau, Chu Pak ; Yeung, Pauline ; Yue, Wen Sheng ; Yin, Li-Xue ; Tse, Hung Fat ; Jiang, Wei ; Lei, Zhen ; Li, Xin-Li ; Cowie, M ; Siu, Chung Wah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b377t-bcbf98e8562656c825a062f1a93aa972d7c5e1ad3f398ef207302714e7ab30f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acute coronary syndromes</topic><topic>acute renal failure</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Beta blockers</topic><topic>Blood pressure</topic><topic>Body composition</topic><topic>Body Size</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Drug dosages</topic><topic>Ejection fraction</topic><topic>Female</topic><topic>Heart Failure</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypertension</topic><topic>ischaemic heart disease</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney - physiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Natriuretic Peptide, Brain</topic><topic>Original research</topic><topic>Pacemakers</topic><topic>Peptides</topic><topic>Population</topic><topic>Prognosis</topic><topic>Stroke Volume</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ho, Mei Han</creatorcontrib><creatorcontrib>Huang, Duo</creatorcontrib><creatorcontrib>Ho, Chi-Wai</creatorcontrib><creatorcontrib>Zuo, Ming-Liang</creatorcontrib><creatorcontrib>Luo, An-Guo</creatorcontrib><creatorcontrib>Cheung, Emmanuel</creatorcontrib><creatorcontrib>Zhou, Mi</creatorcontrib><creatorcontrib>Cheng, Yangyang</creatorcontrib><creatorcontrib>Liu, Mingya</creatorcontrib><creatorcontrib>Yiu, Kai-Hang</creatorcontrib><creatorcontrib>Lau, Chu Pak</creatorcontrib><creatorcontrib>Yeung, Pauline</creatorcontrib><creatorcontrib>Yue, Wen Sheng</creatorcontrib><creatorcontrib>Yin, Li-Xue</creatorcontrib><creatorcontrib>Tse, Hung Fat</creatorcontrib><creatorcontrib>Jiang, Wei</creatorcontrib><creatorcontrib>Lei, Zhen</creatorcontrib><creatorcontrib>Li, Xin-Li</creatorcontrib><creatorcontrib>Cowie, M</creatorcontrib><creatorcontrib>Siu, Chung Wah</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Postgraduate medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ho, Mei Han</au><au>Huang, Duo</au><au>Ho, Chi-Wai</au><au>Zuo, Ming-Liang</au><au>Luo, An-Guo</au><au>Cheung, Emmanuel</au><au>Zhou, Mi</au><au>Cheng, Yangyang</au><au>Liu, Mingya</au><au>Yiu, Kai-Hang</au><au>Lau, Chu Pak</au><au>Yeung, Pauline</au><au>Yue, Wen Sheng</au><au>Yin, Li-Xue</au><au>Tse, Hung Fat</au><au>Jiang, Wei</au><au>Lei, Zhen</au><au>Li, Xin-Li</au><au>Cowie, M</au><au>Siu, Chung Wah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body volume is the major determinant of worsening renal function in acutely decompensated heart failure with reduced left ventricular ejection fraction</atitle><jtitle>Postgraduate medical journal</jtitle><stitle>Postgrad Med J</stitle><addtitle>Postgrad Med J</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>98</volume><issue>1159</issue><spage>333</spage><epage>340</epage><pages>333-340</pages><issn>0032-5473</issn><eissn>1469-0756</eissn><abstract>AimsLittle is known about the relative importance of body volume and haemodynamic parameters in the development of worsening of renal function in acutely decompensated heart failure (ADHF). To study the relationship between haemodynamic parameters, body water content and worsening of renal function in patients with heart failure with reduced ejection fraction (HFrEF) hospitalised for ADHF.Methods and resultsThis prospective observational study involved 51 consecutive patients with HFrEF (age: 73±14 years, male: 60%, left ventricular ejection fraction: 33.3%±9.9%) hospitalised for ADHF. Echocardiographic-determined haemodynamic parameters and body volume determined using a bioelectric impedance analyser were serially obtained. All patients received intravenous furosemide 160 mg/day for 3 days. There was a mean weight loss of 3.95±2.82 kg (p<0.01), and brain natriuretic peptide (BNP) reduced from 1380±901 pg/mL to 797±738 pg/mL (p<0.01). Nonetheless serum creatinine (SCr) increased from 134±46 μmol/L to 151±53 μmol/L (p<0.01), and 35% of patients developed worsening of renal function. The change in SCr was positively correlated with age (r=0.34, p=0.017); and negatively with the ratio of extracellular water to total body water, a parameter of body volume status (r=−0.58, p<0.001); E:E’ ratio (r=−0.36, p=0.01); right ventricular systolic pressure (r=−0.40, p=0.009); and BNP (r=−0.40, p=0.004). Counterintuitively, no correlation was observed between SCr and cardiac output, or total peripheral vascular resistance. Regression analysis revealed that normal body volume and lower BNP independently predicted worsening of renal function.ConclusionsNormal body volume and lower serum BNP on admission were associated with worsening of renal function in patients with HFrEF hospitalised for ADHF.</abstract><cop>England</cop><pub>The Fellowship of Postgraduate Medicine</pub><pmid>33593808</pmid><doi>10.1136/postgradmedj-2020-139023</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3526-8950</orcidid><orcidid>https://orcid.org/0000-0002-2666-3086</orcidid></addata></record> |
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| subjects | Acute coronary syndromes acute renal failure Aged Aged, 80 and over Beta blockers Blood pressure Body composition Body Size Cardiac arrhythmia Cardiovascular disease Creatinine Diabetes Drug dosages Ejection fraction Female Heart Failure Hemodynamics Humans Hypertension ischaemic heart disease Kidney - diagnostic imaging Kidney - physiology Male Middle Aged Mortality Natriuretic Peptide, Brain Original research Pacemakers Peptides Population Prognosis Stroke Volume Ventricular Function, Left |
| title | Body volume is the major determinant of worsening renal function in acutely decompensated heart failure with reduced left ventricular ejection fraction |
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