Renal function during hospitalization and outcome in Chinese patients with acute decompensated heart failure: A retrospective study and literature review
Background The heart and kidneys had demonstrated a bidirectional interaction that dysfunction of the heart or kidneys can induce dysfunction in the other organ. Hypothesis Renal function and its decline during hospitalization may have impact on cardiovascular outcomes in patients with acute decompe...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2023-01, Vol.46 (1), p.57-66 |
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| creator | Lee, Hao‐Wei Huang, Chin‐Chou Yang, Chih‐Yu Leu, Hsin‐Bang Huang, Po‐Hsun Wu, Tao‐Cheng Lin, Shing‐Jong Chen, Jaw‐Wen |
| description | Background
The heart and kidneys had demonstrated a bidirectional interaction that dysfunction of the heart or kidneys can induce dysfunction in the other organ.
Hypothesis
Renal function and its decline during hospitalization may have impact on cardiovascular outcomes in patients with acute decompensated heart failure (ADHF).
Methods
A total of 119 consecutive Chinese patients admitted for ADHF were prospectively enrolled. The course of renal function was presented with estimated glomerular filtration rate (eGFR), calculated by the four‐variable equation proposed by the Modification of Diet in Renal Disease (MDRD) Study. Worsening renal function (WRF) was defined as eGFR decline between admission (eGFRadmission) and predischarge (eGFRpredischarge). Clinical outcomes were defined as 4P‐major adverse cardiovascular events (4P‐MACE), including the composition of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and nonfatal HF hospitalization.
Results
During an average 2.6 ± 3.2 years follow‐up, 66 patients (55%) experienced 4P‐MACE. Patients with impaired eGFRpredischarge ( |
| doi_str_mv | 10.1002/clc.23934 |
| format | Article |
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The heart and kidneys had demonstrated a bidirectional interaction that dysfunction of the heart or kidneys can induce dysfunction in the other organ.
Hypothesis
Renal function and its decline during hospitalization may have impact on cardiovascular outcomes in patients with acute decompensated heart failure (ADHF).
Methods
A total of 119 consecutive Chinese patients admitted for ADHF were prospectively enrolled. The course of renal function was presented with estimated glomerular filtration rate (eGFR), calculated by the four‐variable equation proposed by the Modification of Diet in Renal Disease (MDRD) Study. Worsening renal function (WRF) was defined as eGFR decline between admission (eGFRadmission) and predischarge (eGFRpredischarge). Clinical outcomes were defined as 4P‐major adverse cardiovascular events (4P‐MACE), including the composition of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and nonfatal HF hospitalization.
Results
During an average 2.6 ± 3.2 years follow‐up, 66 patients (55%) experienced 4P‐MACE. Patients with impaired eGFRpredischarge (<60 ml/min/1.73 m2) had more 4P‐MACE than those with preserved eGFRpredischarge (64.7% vs. 43.1%, p = .019). The Kaplan–Meier survival curves showed significantly higher incidence of 4P‐MACE in patients with impaired eGFRpredischarge than those with preserved eGFRpredischarge (p = .002). Cox regression analysis revealed that impaired eGFRpredischarge was significantly correlated with the development of 4P‐MACE (hazard ratio, 2.003; 95% confidence interval, 1.072–3.744; p = .029). In contrast, outcomes would be similar with regard to eGFR on admission and eGFR decline during hospitalization.
Conclusions
Impaired renal function before discharge, but not impaired renal function on admission or WRF, is a significant risk factor for poor outcomes in patients with ADHF.</description><identifier>ISSN: 0160-9289</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.23934</identifier><identifier>PMID: 36345665</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>acute decompensated heart failure ; Beta blockers ; Body mass index ; Cardiac arrhythmia ; Cardiovascular disease ; cardiovascular event ; Clinical Investigations ; Clinical outcomes ; Creatinine ; Diabetes ; Diuretics ; East Asian People ; Ejection fraction ; Enzymes ; Glomerular Filtration Rate ; Heart attacks ; Heart failure ; Heart Failure - diagnosis ; Heart Failure - epidemiology ; Heart Failure - therapy ; High density lipoprotein ; Hospitalization ; Humans ; Hyperlipidemia ; Hypertension ; Kidney - physiology ; Kidney diseases ; Laboratories ; Mortality ; Patients ; Peptides ; Prognosis ; renal function ; Retrospective Studies ; Statistical analysis ; Survival analysis ; worsening renal function</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2023-01, Vol.46 (1), p.57-66</ispartof><rights>2022 The Authors. published by Wiley Periodicals, LLC.</rights><rights>2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4434-c49cc05fd037dd4019692d4f9d3954b18e3152e8919d358dd3a0520d81f38ae13</citedby><cites>FETCH-LOGICAL-c4434-c49cc05fd037dd4019692d4f9d3954b18e3152e8919d358dd3a0520d81f38ae13</cites><orcidid>0000-0002-4217-8734 ; 0000-0002-2159-3509</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9849437/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9849437/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36345665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Hao‐Wei</creatorcontrib><creatorcontrib>Huang, Chin‐Chou</creatorcontrib><creatorcontrib>Yang, Chih‐Yu</creatorcontrib><creatorcontrib>Leu, Hsin‐Bang</creatorcontrib><creatorcontrib>Huang, Po‐Hsun</creatorcontrib><creatorcontrib>Wu, Tao‐Cheng</creatorcontrib><creatorcontrib>Lin, Shing‐Jong</creatorcontrib><creatorcontrib>Chen, Jaw‐Wen</creatorcontrib><title>Renal function during hospitalization and outcome in Chinese patients with acute decompensated heart failure: A retrospective study and literature review</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>Background
The heart and kidneys had demonstrated a bidirectional interaction that dysfunction of the heart or kidneys can induce dysfunction in the other organ.
Hypothesis
Renal function and its decline during hospitalization may have impact on cardiovascular outcomes in patients with acute decompensated heart failure (ADHF).
Methods
A total of 119 consecutive Chinese patients admitted for ADHF were prospectively enrolled. The course of renal function was presented with estimated glomerular filtration rate (eGFR), calculated by the four‐variable equation proposed by the Modification of Diet in Renal Disease (MDRD) Study. Worsening renal function (WRF) was defined as eGFR decline between admission (eGFRadmission) and predischarge (eGFRpredischarge). Clinical outcomes were defined as 4P‐major adverse cardiovascular events (4P‐MACE), including the composition of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and nonfatal HF hospitalization.
Results
During an average 2.6 ± 3.2 years follow‐up, 66 patients (55%) experienced 4P‐MACE. Patients with impaired eGFRpredischarge (<60 ml/min/1.73 m2) had more 4P‐MACE than those with preserved eGFRpredischarge (64.7% vs. 43.1%, p = .019). The Kaplan–Meier survival curves showed significantly higher incidence of 4P‐MACE in patients with impaired eGFRpredischarge than those with preserved eGFRpredischarge (p = .002). Cox regression analysis revealed that impaired eGFRpredischarge was significantly correlated with the development of 4P‐MACE (hazard ratio, 2.003; 95% confidence interval, 1.072–3.744; p = .029). In contrast, outcomes would be similar with regard to eGFR on admission and eGFR decline during hospitalization.
Conclusions
Impaired renal function before discharge, but not impaired renal function on admission or WRF, is a significant risk factor for poor outcomes in patients with ADHF.</description><subject>acute decompensated heart failure</subject><subject>Beta blockers</subject><subject>Body mass index</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>cardiovascular event</subject><subject>Clinical Investigations</subject><subject>Clinical outcomes</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Diuretics</subject><subject>East Asian People</subject><subject>Ejection fraction</subject><subject>Enzymes</subject><subject>Glomerular Filtration Rate</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - therapy</subject><subject>High density lipoprotein</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Hyperlipidemia</subject><subject>Hypertension</subject><subject>Kidney - physiology</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Mortality</subject><subject>Patients</subject><subject>Peptides</subject><subject>Prognosis</subject><subject>renal function</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Survival analysis</subject><subject>worsening renal function</subject><issn>0160-9289</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kV1rFDEUhoModq1e-Ack4I1ebJvPmYkXQhnqBywIotchTc50UrKZNcnssv4T_23T3VpU8CaBcx6enJMXoZeUnFFC2LkN9oxxxcUjtKCKs2XX8vYxWhDakKVinTpBz3K-qSjpGH-KTnjDhWwauUC_vkI0AQ9ztMVPEbs5-XiNxylvfDHB_zSHsokOT3Ox0xqwj7gffYQMeFO7EEvGO19GbOxcADuo1AZiNgUcHsGkggfjw5zgHb7ACUqqcqjPbQHnMrv9wR58gWRKpSqy9bB7jp4MJmR4cX-fou8fLr_1n5arLx8_9xerpRWCi3oqa4kcHOGtc4JQ1SjmxKAcV1Jc0Q44lQw6RWtFds5xQyQjrqMD7wxQforeH72b-WoNztZ9kgl6k_zapL2ejNd_d6If9fW01aoTSvC2Ct7cC9L0Y4Zc9NpnCyGYCNOcNWu5oI2UTFT09T_ozTSnGsAdVfNoGiFJpd4eKVt_KicYHoahRN8Frmvg-hB4ZV_9Of0D-TvhCpwfgZ0PsP-_Sfer_qi8BSTNuNQ</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Lee, Hao‐Wei</creator><creator>Huang, Chin‐Chou</creator><creator>Yang, Chih‐Yu</creator><creator>Leu, Hsin‐Bang</creator><creator>Huang, Po‐Hsun</creator><creator>Wu, Tao‐Cheng</creator><creator>Lin, Shing‐Jong</creator><creator>Chen, Jaw‐Wen</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><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>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4217-8734</orcidid><orcidid>https://orcid.org/0000-0002-2159-3509</orcidid></search><sort><creationdate>202301</creationdate><title>Renal function during hospitalization and outcome in Chinese patients with acute decompensated heart failure: A retrospective study and literature review</title><author>Lee, Hao‐Wei ; Huang, Chin‐Chou ; Yang, Chih‐Yu ; Leu, Hsin‐Bang ; Huang, Po‐Hsun ; Wu, Tao‐Cheng ; Lin, Shing‐Jong ; Chen, Jaw‐Wen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4434-c49cc05fd037dd4019692d4f9d3954b18e3152e8919d358dd3a0520d81f38ae13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>acute decompensated heart failure</topic><topic>Beta blockers</topic><topic>Body mass index</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>cardiovascular event</topic><topic>Clinical Investigations</topic><topic>Clinical outcomes</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Diuretics</topic><topic>East Asian People</topic><topic>Ejection fraction</topic><topic>Enzymes</topic><topic>Glomerular Filtration Rate</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - therapy</topic><topic>High density lipoprotein</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Hyperlipidemia</topic><topic>Hypertension</topic><topic>Kidney - physiology</topic><topic>Kidney diseases</topic><topic>Laboratories</topic><topic>Mortality</topic><topic>Patients</topic><topic>Peptides</topic><topic>Prognosis</topic><topic>renal function</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Survival analysis</topic><topic>worsening renal function</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Hao‐Wei</creatorcontrib><creatorcontrib>Huang, Chin‐Chou</creatorcontrib><creatorcontrib>Yang, Chih‐Yu</creatorcontrib><creatorcontrib>Leu, Hsin‐Bang</creatorcontrib><creatorcontrib>Huang, Po‐Hsun</creatorcontrib><creatorcontrib>Wu, Tao‐Cheng</creatorcontrib><creatorcontrib>Lin, Shing‐Jong</creatorcontrib><creatorcontrib>Chen, Jaw‐Wen</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><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>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>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 Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Hao‐Wei</au><au>Huang, Chin‐Chou</au><au>Yang, Chih‐Yu</au><au>Leu, Hsin‐Bang</au><au>Huang, Po‐Hsun</au><au>Wu, Tao‐Cheng</au><au>Lin, Shing‐Jong</au><au>Chen, Jaw‐Wen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Renal function during hospitalization and outcome in Chinese patients with acute decompensated heart failure: A retrospective study and literature review</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2023-01</date><risdate>2023</risdate><volume>46</volume><issue>1</issue><spage>57</spage><epage>66</epage><pages>57-66</pages><issn>0160-9289</issn><eissn>1932-8737</eissn><abstract>Background
The heart and kidneys had demonstrated a bidirectional interaction that dysfunction of the heart or kidneys can induce dysfunction in the other organ.
Hypothesis
Renal function and its decline during hospitalization may have impact on cardiovascular outcomes in patients with acute decompensated heart failure (ADHF).
Methods
A total of 119 consecutive Chinese patients admitted for ADHF were prospectively enrolled. The course of renal function was presented with estimated glomerular filtration rate (eGFR), calculated by the four‐variable equation proposed by the Modification of Diet in Renal Disease (MDRD) Study. Worsening renal function (WRF) was defined as eGFR decline between admission (eGFRadmission) and predischarge (eGFRpredischarge). Clinical outcomes were defined as 4P‐major adverse cardiovascular events (4P‐MACE), including the composition of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and nonfatal HF hospitalization.
Results
During an average 2.6 ± 3.2 years follow‐up, 66 patients (55%) experienced 4P‐MACE. Patients with impaired eGFRpredischarge (<60 ml/min/1.73 m2) had more 4P‐MACE than those with preserved eGFRpredischarge (64.7% vs. 43.1%, p = .019). The Kaplan–Meier survival curves showed significantly higher incidence of 4P‐MACE in patients with impaired eGFRpredischarge than those with preserved eGFRpredischarge (p = .002). Cox regression analysis revealed that impaired eGFRpredischarge was significantly correlated with the development of 4P‐MACE (hazard ratio, 2.003; 95% confidence interval, 1.072–3.744; p = .029). In contrast, outcomes would be similar with regard to eGFR on admission and eGFR decline during hospitalization.
Conclusions
Impaired renal function before discharge, but not impaired renal function on admission or WRF, is a significant risk factor for poor outcomes in patients with ADHF.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>36345665</pmid><doi>10.1002/clc.23934</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-4217-8734</orcidid><orcidid>https://orcid.org/0000-0002-2159-3509</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Online Library Open Access; PubMed Central |
| subjects | acute decompensated heart failure Beta blockers Body mass index Cardiac arrhythmia Cardiovascular disease cardiovascular event Clinical Investigations Clinical outcomes Creatinine Diabetes Diuretics East Asian People Ejection fraction Enzymes Glomerular Filtration Rate Heart attacks Heart failure Heart Failure - diagnosis Heart Failure - epidemiology Heart Failure - therapy High density lipoprotein Hospitalization Humans Hyperlipidemia Hypertension Kidney - physiology Kidney diseases Laboratories Mortality Patients Peptides Prognosis renal function Retrospective Studies Statistical analysis Survival analysis worsening renal function |
| title | Renal function during hospitalization and outcome in Chinese patients with acute decompensated heart failure: A retrospective study and literature review |
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