Key result
In-hospital renal function changes predicted 2-year all-cause mortality and cardiovascular readmission in ADHF with CKD and severe edema (HR 3.2; 95% CI 1.40-7.30; p=0.004).
Why the study?
The risks of CKD progression and the long-term prognosis of patients with ADHF and edema, depending on in-hospital changes in renal function, needed to be determined.
Does worsening renal function during inpatient treatment influence the 2-year composite outcome of all-cause mortality and cardiovascular readmissions in patients with acute decompensated heart failure, chronic kidney disease, and severe edema?
Cohort (n=95)
No
Does worsening renal function during inpatient treatment influence the 2-year composite outcome of all-cause mortality and cardiovascular readmissions in patients with acute decompensated heart failure, chronic kidney disease, and severe edema?
Answers are grounded in this paper and cite their sources.
In patients hospitalized for acute decompensated heart failure with severe edema and pre-existing CKD, transient worsening of renal function during inpatient therapy was associated with a more favorable 2-year prognosis regarding mortality and ADHF readmissions compared to having no change in renal function.
Aim . To determine the risks of chronic kidney disease (CKD) progression and the long-term prognosis of patients with acute decompensated heart failure (ADHF) and edema, depending on changes in renal function during hospitalization. Material and methods. A cohort of 95 patients with diagnosed ADHF, a history of confirmed CKD, and heart failure (HF) with severe edema was enrolled. Patients were hospitalized at City Clinical Hospital № 38 in Nizhny Novgorod (Regional Center for HF). Assessments were performed on the day of admission, on the 7th day of hospitalization, and on the day of discharge. Renal function changes were categorized into three trajectories: improvement, worsening, and no change. The long-term prognosis was evaluated over a 2-year period. The composite endpoint included all-cause mortality and cardiovascular-related hospital readmissions. All readmissions were due to ADHF. Results . In the group of patients with worsening renal function (WRF), no significant increase in furosemide dosage was observed during hospitalization compared to the group without WRF, where a significant increase in furosemide dosage was identified. Kaplan-Meier survival analysis confirmed that patients who did not experience WRF during hospitalization reached the composite endpoint more frequently than those who did (Log-Rank p=0,006). According to the multivariate Cox proportional hazards model, none of the included factors influenced the prognosis regarding the composite endpoint (all-cause mortality + cardiovascular rehospitalizations), with the exception of changes (worsening) in renal function during inpatient treatment (HR 3,2; 95% CI: 1,40-7,30; p=0,004). Conclusion . The dynamics (worsening or no change) of renal function in patients with ADHF and severe edema during inpatient treatment is not associated with hospital-based heart failure therapy, including diuretics, and serves as a predictor of a favorable long-term prognosis regarding the composite outcome over a 2-year period. Conversely, the absence of significant changes in renal function during the period of ADHF and edema against the background of therapy may be a predictor of an unfavorable long-term prognosis regarding the composite outcome in this category of patients.
No takes yet. Share an insight, caveat, or question.
Dzhabbarov et al. (2026) conducted a cohort in Acute decompensated heart failure with severe edema and chronic kidney disease (n=95). Worsening renal function during hospitalization vs. No worsening of renal function during hospitalization was evaluated on Composite of all-cause mortality and cardiovascular-related hospital readmissions due to ADHF (HR 3.2, 95% CI 1.40-7.30, p=0.004). In-hospital renal function changes predicted 2-year all-cause mortality and cardiovascular readmission in ADHF with CKD and severe edema (HR 3.2; 95% CI 1.40-7.30; p=0.004).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: