Key result
Worsening renal function in systolic heart failure is linked to ~12% higher in-hospital mortality.
Why the study?
Renal impairment is common in heart failure and characterized by worsening renal function (WRF), but its prevalence and risk factors in hospitalized systolic heart failure patients required determination.
Cross-Sectional (n=347)
No
Absolute Event Rate: 11.9% vs 0%
p-value: p=<0.001
In hospitalized patients with HFrEF, worsening renal function occurs in approximately one-third of cases and is independently predicted by hyponatremia, hemoglobin concentration, white blood cell count, and prior diuretic use, leading to higher mortality and longer hospital stays.
Signals markedly elevated in-hospital mortality in systolic heart failure; extends observational data but leaves open interventional trials.
AIMS: Heart failure (HF) is usually associated with complications of other organs. Renal impairment is seen in a significant proportion of HF patients and is characterized by worsening renal function (WRF). WRF can be used for predicting symptom exacerbation in systolic HF. This study aimed to determine the prevalence and risk factors of WRF among hospitalized patients with systolic HF. METHODS AND RESULTS: In this cross-sectional study, data from medical records of 347 hospitalized patients diagnosed with HFrEF from 2019 to 2020, admitted to Tabriz Shahid Madani Heart Hospital, who met the predefined inclusion criteria, were retrieved. Patients were divided into two groups based on the in-hospital occurrence of WRF. Laboratory tests and para-clinical findings were collected and analysed using SPSS Version 20.0. Statistical significance was accepted at a P value of <0.05. In this study, 347 hospitalized patients with HFrEF were included. The mean (standard deviation) age was 62.34 (±18.87) years. The mean (SD) length of stay was 6.34 (±4) days. According to our findings, 117 patients (33.71%) had WRF. Following multivariate analysis of potential predictors of WRF occurrence, hyponatremia, haemoglobin concentration, white blood cell count and prior diuretic use were found to be independent predictors for WRF occurrence in patients with systolic heart failure. CONCLUSIONS: This study revealed that in patients with WRF, mortality rate and length of stay were significantly greater than those of patients without WRF. Initial clinical characteristics of HF patients who developed WRF can help physicians identify patients with a higher risk of WRF.
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Asbagh et al. (2023) conducted a cross-sectional in Systolic heart failure (HFrEF) (n=347). Worsening renal function (WRF) vs. No worsening renal function was evaluated on In-hospital mortality (p=<0.001). Worsening renal function occurred in 33.7% of hospitalized patients with systolic heart failure and was associated with significantly higher in-hospital mortality compared to those without worsening renal function (11.9% vs 0%, p<0.001).
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