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Prognostic value of renal function in patients with acute decompensation of chronic heart failure

Abstract

Aim. To study renal function and prognostic value of creatinine and glomerular filtration rate (GFR) levels in regard to lethality among patients with acute decompensation of chronic heart failure (AD CHF).

Material and methods. Fhe study included 392 patients hospitalized with AD CHF symptoms (mean age 65,2+8,4 years; 263 (68%) males; CHF duration - 3,6 years). Serum creatinine concentration was measured daily up to Day 7 of hospitalization. Persistently elevated creatinine level by at least 26,5 mkmol/1 pointed to deteriorating renal function. GFR was calculated according to Cockroft-Gault formula. Echocardiography at admission was performed in all participants.

Results. Baseline renal dysfunction (GFR<90 ml/min/1,73 m2) was observed in 270 (69%) patients, hospitalized with AD CHF. Severe renal failure (RF) - GFR<30 ml/min/1,73 m2, was observed in 54 (20%) subjects, including 11 (4%) with terminal RF - GFR<15 ml/min/1,73 m2. Deterioration of renal function during hospitalization was registered in 120 (30,6%) patients, being linked mostly to CHF duration. In this group, 13 (10,8%) patients died - substantially more than in participants without progressing renal dysfunction (19 (7%) deaths).

Conclusion. In patients hospitalized with AD CHF, baseline GFR decrease was observed in 69%, including 20% with severe renal dysfunction (GFR<30 ml/min/1,73 m2). Renal dysfunction progression during hospitalization, registered in 30,6% of AD CHF patients, was linked to CHF duration and higher lethality.

About the Authors

I. A. Meray
Russian University of People’s Friendship, City Clinical Hospital No. 64. Moscow
Russian Federation


A. Yu. Yurovsky
Russian University of People’s Friendship, City Clinical Hospital No. 64. Moscow
Russian Federation


E. P. Pavlikova
Russian University of People’s Friendship, City Clinical Hospital No. 64. Moscow
Russian Federation


M. A. Efremovtseva
Russian University of People’s Friendship, City Clinical Hospital No. 64. Moscow
Russian Federation


V. S. Moiseev
Russian University of People’s Friendship, City Clinical Hospital No. 64. Moscow
Russian Federation


References

1. Мухин Н.А., Моисеев B.C., Кобалава Ж.Д. и др. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе заболеваний сердечнососудистой системы и почек. Тер архив 2004; 6: 39-46.

2. Дмитрова Т.Е., Кобалава Ж.Д. Кардиоренальный синдром. РМЖ 2003; 11(12): 699-703.

3. Ruilope L.M., Salvetti A., Jamerson К., et al. Renal Function and Intensive Lowering of Blood Pressure in Hypertensive Participants of the Hypertension Optimal Treatment (HOT) Study. J Am Soc Nephrol 2001; 12(2): 218-25.

4. Kidney Disease Outcome Quality Initiative. Clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis 2002; 39 (Suppl.2): Sl-246.

5. Mahan N.G., Blackstone E.H., Francis G.S., et al. The prognostic value of estimated creatinine clearance alongside functional capacity in patients with chronic congestive heart failure. JACC 2002;40:1106-13.

6. Dries D.L., Exner D.V., Domanski M.J., et al. The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction. JACC 2000; 35: 681-9.

7. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNCVII). JAMA 2003; 289(19): 2560-72.

8. Forman D.E., Butler J., Wang Y., et al. Incidence, predictors at admission, and impact of worsening renal function among patients hospitalized with heart failure. JACC 2004; 43: 61-7.

9. Smith G.L., Vaccarino V., Kosiborod M., et al. Worsening renal function: what is a clinically meaningful change in creatinine during hospitalization with heart failure? J Card Fail 2003; 9: 13-25.

10. Gheorghiade M., Filippato G. Reassessing treatment of acute heart failure syndromes: the ADHERE Registry. EHJ 2005; 7 (Supplement B): 13-9.

11. Терещенко C.H., Жиров И.В. Место ингибиторов ангиотензин-превращающего фермента влечении кардиоре-налвного синдрома. Consmed 2007; 09(5): 17-21.

12. Gottlieb S.S., Abraham W., Butler J., et al. The prognostic importance of different definitions of worsening renal function in congestive heart failure. J Card Fail 2002; 8: 136-41.

13. Krumholz H.M., Chen Y.T., Vaccarino V., et al. Correlates and impact on outcomes of worsening renal function in patients < or >65 years of age with heart failure. Am J Cardiol 2000; 85: 1110-3.

14. Hillege H.L., Girbes A.R., de Kam P.J., et al. Renal function, neurohormonal activation, and survival in patients with chronic heart failure. Circulation 2000; 102: 203-10.


Review

For citations:


Meray I.A., Yurovsky A.Yu., Pavlikova E.P., Efremovtseva M.A., Moiseev V.S. Prognostic value of renal function in patients with acute decompensation of chronic heart failure. Cardiovascular Therapy and Prevention. 2008;7(4):54-58. (In Russ.)

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)