Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2009 Oct 21:10:31.
doi: 10.1186/1471-2369-10-31.

Chronic kidney disease increases cardiovascular unfavourable outcomes in outpatients with heart failure

Arise G S Galil  1 , Hélady S Pinheiro, Alfredo Chaoubah, Darcília M N Costa, Marcus G Bastos
Affiliations
Comparative Study

Chronic kidney disease increases cardiovascular unfavourable outcomes in outpatients with heart failure

Arise G S Galil et al. BMC Nephrol. .

Abstract

Background: Chronic heart failure (CHF) has a high morbidity and mortality. Chronic kidney disease (CKD) has consistently been found to be an independent risk factor for unfavorable cardiovascular (CV) outcomes. Early intervention on CKD reduces the progression of CHF, hospitalizations and mortality, yet there are very few studies about CKD as a risk factor in the early stages of CHF. The aims of our study were to assess the prevalence and the prognostic importance of CKD in patients with systolic CHF stages B and C.

Methods: This is a prospective cohort study, dealing with prognostic markers for CV endpoints in patients with systolic CHF (ejection fraction <or= 45%).

Results: CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2 and CV endpoints as death or hospitalization due to CHF, in 12 months follow-up. Eighty three patients were studied, the mean age was 62.7 +/- 12 years, and 56.6% were female. CKD was diagnosed in 49.4% of the patients, 33% of patients with CHF stage B and 67% in the stage C. Cardiovascular endpoints were observed in 26.5% of the patients. When the sample was stratified into stages B and C of CHF, the occurrence of CKD was associated with 100% and 64.7%, respectively, of unfavorable CV outcomes. After adjustments for all other prognostic factors at baseline, it was observed that the diagnosis of CKD increased in 3.6 times the possibility of CV outcomes (CI 95% 1.04-12.67, p = 0.04), whereas higher ejection fraction (R = 0.925, IC 95% 0.862-0.942, p = 0.03) and serum sodium (R = 0.807, IC 95% 0.862-0.992, p = 0.03) were protective.

Conclusion: In this cohort of patients with CHF stages B and C, CKD was prevalent and independently associated with increased risk of hospitalization and death secondary to cardiac decompensation, especially in asymptomatic patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Presents the cardiovascular outcomes related to the presence or not of chronic kidney disease (CKD) in patients with the chronic heart failure as whole (CHFT), and after stratification by stages B (CHFB) and C (CHFC).
See this image and copyright information in PMC

References

    1. Diretrizes. Revisão das II Diretrizes da Sociedade Brasileira de Cardiologia para o Diagnóstico e Tratamento da Insuficiência Cardíaca. Arq Bras Cardiol. 2002;79(Supl IV):1–30. - PubMed
    1. Diretrizes. I. Diretriz Latino-Americana para Avaliação e Conduta na Insuficiência Cardíaca Descompensada. Arq Bras Cardiol. 2005;85(Supl III):1–48.
    1. Hunt SA. American College of Cardiology; American Heart Association Task Force on Practice Guidelines (Writing Commiitee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure) J Am Coll Cardiol. 2005;46(6):e1–82. doi: 10.1016/j.jacc.2005.08.022. - DOI - PubMed
    1. Jessup M, Brozena S. Heart Failure. N Eng J Med. 2003;348(20):2007–2018. doi: 10.1056/NEJMra021498. - DOI - PubMed
    1. Tavares LR, Victor H, Linhares JM, Barros CM, Oliveira MV, Pacheco LC. Epidemiologia da Insuficiência Cardíaca Descompensada em Niterói - Projeto EPICA - Niterói. Arq Bras Cardiol. 2004;82(2):121–4. doi: 10.1590/S0066-782X2004000200003. - DOI - PubMed

Publication types