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. 2008 Feb;10(2):188-95.
doi: 10.1016/j.ejheart.2008.01.011.

Worsening renal function in patients hospitalised for acute heart failure: clinical implications and prognostic significance

Marco Metra  1 , 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
Affiliations
Free article

Worsening renal function in patients hospitalised for acute heart failure: clinical implications and prognostic significance

Marco Metra et al. Eur J Heart Fail. 2008 Feb.
Free article

Abstract

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.

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