Relationship between heart failure treatment and development of worsening renal function among hospitalized patients
Among patients who are hospitalized with heart failure (HF), worsening renal function (WRF) is associated with worse outcomes. Whether treatment for HF contributes to WRF is unknown. In this study, we sought to assess whether acute treatment for patients who were hospitalized with HF contributes to...
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| Veröffentlicht in: | The American heart journal 2004-02, Vol.147 (2), p.331-338 |
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| creator | Butler, Javed Forman, Daniel E Abraham, William T Gottlieb, Stephen S Loh, Evan Massie, Barry M O'Connor, Christopher M Rich, Michael W Stevenson, Lynne Warner Wang, Yongfei Young, James B Krumholz, Harlan M |
| description | Among patients who are hospitalized with heart failure (HF), worsening renal function (WRF) is associated with worse outcomes. Whether treatment for HF contributes to WRF is unknown. In this study, we sought to assess whether acute treatment for patients who were hospitalized with HF contributes to WRF.
Data were collected in a nested case-control study on 382 subjects who were hospitalized with HF (191 patients with WRF, defined as a rise in serum creatinine level >26.5 μmol/L [0.3 mg/dL], and 191 control subjects). The association of medications, fluid intake/output, and weight with WRF was assessed.
Calcium channel blocker (CCB) use and loop diuretic doses were higher in patients on the day before WRF (25% vs 10% for CCB; 199 ± 195 mg vs 143 ± 119 mg for loop diuretics; both
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| doi_str_mv | 10.1016/j.ahj.2003.08.012 |
| format | Article |
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Data were collected in a nested case-control study on 382 subjects who were hospitalized with HF (191 patients with WRF, defined as a rise in serum creatinine level >26.5 μmol/L [0.3 mg/dL], and 191 control subjects). The association of medications, fluid intake/output, and weight with WRF was assessed.
Calcium channel blocker (CCB) use and loop diuretic doses were higher in patients on the day before WRF (25% vs 10% for CCB; 199 ± 195 mg vs 143 ± 119 mg for loop diuretics; both
P <.05). There were no significant differences in the fluid intake/output or weight changes in the 2 groups. Angiotensin-converting enzyme (ACE) inhibitor use was not associated with WRF. Other predictors of WRF included elevated creatinine level at admission, uncontrolled hypertension, and history of HF or diabetes mellitus. Higher hematocrit levels were associated with a lower risk. Vasodilator use was higher among patients on the day before WRF (46% vs 35%,
P <.05), but was not an independent predictor in the multivariable analysis.
Several medical strategies, including the use of CCBs and a higher dose of loop diuretics, but not ACE inhibitors, were associated with a higher risk of WRF. Although assessment of inhospital diuresis was limited, WRF could not be explained by greater fluid loss in these patients. Determining whether these interventions are responsible for WRF or are markers of higher risk requires further investigation.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2003.08.012</identifier><identifier>PMID: 14760333</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Analysis of Variance ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Biological and medical sciences ; Calcium Channel Blockers - adverse effects ; Calcium Channel Blockers - therapeutic use ; Cardiology. Vascular system ; Case-Control Studies ; Cohort Studies ; Creatinine - blood ; Diuretics - adverse effects ; Diuretics - therapeutic use ; Female ; Heart ; Heart Failure - complications ; Heart Failure - drug therapy ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Hospitalization ; Humans ; Kidney Diseases - etiology ; Male ; Medical sciences ; Middle Aged ; Renal Insufficiency - complications ; Risk Factors</subject><ispartof>The American heart journal, 2004-02, Vol.147 (2), p.331-338</ispartof><rights>2004 Mosby, Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ahj.2003.08.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15583069$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14760333$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Butler, Javed</creatorcontrib><creatorcontrib>Forman, Daniel E</creatorcontrib><creatorcontrib>Abraham, William T</creatorcontrib><creatorcontrib>Gottlieb, Stephen S</creatorcontrib><creatorcontrib>Loh, Evan</creatorcontrib><creatorcontrib>Massie, Barry M</creatorcontrib><creatorcontrib>O'Connor, Christopher M</creatorcontrib><creatorcontrib>Rich, Michael W</creatorcontrib><creatorcontrib>Stevenson, Lynne Warner</creatorcontrib><creatorcontrib>Wang, Yongfei</creatorcontrib><creatorcontrib>Young, James B</creatorcontrib><creatorcontrib>Krumholz, Harlan M</creatorcontrib><title>Relationship between heart failure treatment and development of worsening renal function among hospitalized patients</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Among patients who are hospitalized with heart failure (HF), worsening renal function (WRF) is associated with worse outcomes. Whether treatment for HF contributes to WRF is unknown. In this study, we sought to assess whether acute treatment for patients who were hospitalized with HF contributes to WRF.
Data were collected in a nested case-control study on 382 subjects who were hospitalized with HF (191 patients with WRF, defined as a rise in serum creatinine level >26.5 μmol/L [0.3 mg/dL], and 191 control subjects). The association of medications, fluid intake/output, and weight with WRF was assessed.
Calcium channel blocker (CCB) use and loop diuretic doses were higher in patients on the day before WRF (25% vs 10% for CCB; 199 ± 195 mg vs 143 ± 119 mg for loop diuretics; both
P <.05). There were no significant differences in the fluid intake/output or weight changes in the 2 groups. Angiotensin-converting enzyme (ACE) inhibitor use was not associated with WRF. Other predictors of WRF included elevated creatinine level at admission, uncontrolled hypertension, and history of HF or diabetes mellitus. Higher hematocrit levels were associated with a lower risk. Vasodilator use was higher among patients on the day before WRF (46% vs 35%,
P <.05), but was not an independent predictor in the multivariable analysis.
Several medical strategies, including the use of CCBs and a higher dose of loop diuretics, but not ACE inhibitors, were associated with a higher risk of WRF. Although assessment of inhospital diuresis was limited, WRF could not be explained by greater fluid loss in these patients. Determining whether these interventions are responsible for WRF or are markers of higher risk requires further investigation.</description><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Calcium Channel Blockers - adverse effects</subject><subject>Calcium Channel Blockers - therapeutic use</subject><subject>Cardiology. Vascular system</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>Creatinine - blood</subject><subject>Diuretics - adverse effects</subject><subject>Diuretics - therapeutic use</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - drug therapy</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Kidney Diseases - etiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Renal Insufficiency - complications</subject><subject>Risk Factors</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkd9LHDEQx4Moetr-AX0peenjbifJJtnDJxFtBaEg7XPIJrO9HHvZJckp-tebqxZhYJiZz_ziS8gXBi0Dpr5vW7vZthxAtNC3wPgRWTFY60bprjsmKwDgTa9BnJHznLc1VLxXp-SMdVqBEGJFygNOtoQ55k1Y6IDlCTHSDdpU6GjDtE9IS0JbdhgLtdFTj484zcu_eB7p05wyxhD_0oTRTnTcR3eYR-1ursnNnJdQ7BRe0NOlbqpt-RM5Ge2U8fO7vyB_bm9-X_9s7n_9uLu-um-Qr1lpvNfgXSdBdmuteDUpHDgpdK2gG8TAAFAObrQo-aA9F1zZQXV20IhyFBfk69vcZT_s0JslhZ1Nz-b_-xX49g7Y7Ow0JhtdyB-clL0Ata7c5RuH9drHgMlkVz9x6ENCV4yfg2FgDqKYramimIMoBnpTRRGvw_2Bug</recordid><startdate>20040201</startdate><enddate>20040201</enddate><creator>Butler, Javed</creator><creator>Forman, Daniel E</creator><creator>Abraham, William T</creator><creator>Gottlieb, Stephen S</creator><creator>Loh, Evan</creator><creator>Massie, Barry M</creator><creator>O'Connor, Christopher M</creator><creator>Rich, Michael W</creator><creator>Stevenson, Lynne Warner</creator><creator>Wang, Yongfei</creator><creator>Young, James B</creator><creator>Krumholz, Harlan M</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20040201</creationdate><title>Relationship between heart failure treatment and development of worsening renal function among hospitalized patients</title><author>Butler, Javed ; Forman, Daniel E ; Abraham, William T ; Gottlieb, Stephen S ; Loh, Evan ; Massie, Barry M ; O'Connor, Christopher M ; Rich, Michael W ; Stevenson, Lynne Warner ; Wang, Yongfei ; Young, James B ; Krumholz, Harlan M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e291t-dd70dc45054976276253c0c537dd7ecb3b100e5bcfae52b7d2326ab64ab7ee5f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Calcium Channel Blockers - adverse effects</topic><topic>Calcium Channel Blockers - therapeutic use</topic><topic>Cardiology. Vascular system</topic><topic>Case-Control Studies</topic><topic>Cohort Studies</topic><topic>Creatinine - blood</topic><topic>Diuretics - adverse effects</topic><topic>Diuretics - therapeutic use</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - drug therapy</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Kidney Diseases - etiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Renal Insufficiency - complications</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Butler, Javed</creatorcontrib><creatorcontrib>Forman, Daniel E</creatorcontrib><creatorcontrib>Abraham, William T</creatorcontrib><creatorcontrib>Gottlieb, Stephen S</creatorcontrib><creatorcontrib>Loh, Evan</creatorcontrib><creatorcontrib>Massie, Barry M</creatorcontrib><creatorcontrib>O'Connor, Christopher M</creatorcontrib><creatorcontrib>Rich, Michael W</creatorcontrib><creatorcontrib>Stevenson, Lynne Warner</creatorcontrib><creatorcontrib>Wang, Yongfei</creatorcontrib><creatorcontrib>Young, James B</creatorcontrib><creatorcontrib>Krumholz, Harlan M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Butler, Javed</au><au>Forman, Daniel E</au><au>Abraham, William T</au><au>Gottlieb, Stephen S</au><au>Loh, Evan</au><au>Massie, Barry M</au><au>O'Connor, Christopher M</au><au>Rich, Michael W</au><au>Stevenson, Lynne Warner</au><au>Wang, Yongfei</au><au>Young, James B</au><au>Krumholz, Harlan M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between heart failure treatment and development of worsening renal function among hospitalized patients</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2004-02-01</date><risdate>2004</risdate><volume>147</volume><issue>2</issue><spage>331</spage><epage>338</epage><pages>331-338</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Among patients who are hospitalized with heart failure (HF), worsening renal function (WRF) is associated with worse outcomes. Whether treatment for HF contributes to WRF is unknown. In this study, we sought to assess whether acute treatment for patients who were hospitalized with HF contributes to WRF.
Data were collected in a nested case-control study on 382 subjects who were hospitalized with HF (191 patients with WRF, defined as a rise in serum creatinine level >26.5 μmol/L [0.3 mg/dL], and 191 control subjects). The association of medications, fluid intake/output, and weight with WRF was assessed.
Calcium channel blocker (CCB) use and loop diuretic doses were higher in patients on the day before WRF (25% vs 10% for CCB; 199 ± 195 mg vs 143 ± 119 mg for loop diuretics; both
P <.05). There were no significant differences in the fluid intake/output or weight changes in the 2 groups. Angiotensin-converting enzyme (ACE) inhibitor use was not associated with WRF. Other predictors of WRF included elevated creatinine level at admission, uncontrolled hypertension, and history of HF or diabetes mellitus. Higher hematocrit levels were associated with a lower risk. Vasodilator use was higher among patients on the day before WRF (46% vs 35%,
P <.05), but was not an independent predictor in the multivariable analysis.
Several medical strategies, including the use of CCBs and a higher dose of loop diuretics, but not ACE inhibitors, were associated with a higher risk of WRF. Although assessment of inhospital diuresis was limited, WRF could not be explained by greater fluid loss in these patients. Determining whether these interventions are responsible for WRF or are markers of higher risk requires further investigation.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>14760333</pmid><doi>10.1016/j.ahj.2003.08.012</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Analysis of Variance Angiotensin-Converting Enzyme Inhibitors - therapeutic use Biological and medical sciences Calcium Channel Blockers - adverse effects Calcium Channel Blockers - therapeutic use Cardiology. Vascular system Case-Control Studies Cohort Studies Creatinine - blood Diuretics - adverse effects Diuretics - therapeutic use Female Heart Heart Failure - complications Heart Failure - drug therapy Heart failure, cardiogenic pulmonary edema, cardiac enlargement Hospitalization Humans Kidney Diseases - etiology Male Medical sciences Middle Aged Renal Insufficiency - complications Risk Factors |
| title | Relationship between heart failure treatment and development of worsening renal function among hospitalized patients |
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