Chronic kidney disease stages 4-5 in patients with heart failure was associated with higher 1-year mortality (36.1 vs. 14.6 per 100 person-years; p<0.001) compared to CKD stages 1-3.
Cohort (n=2,245)
Yes
Does advanced chronic kidney disease (stages 4-5) worsen 1-year mortality and HF hospitalization rates in patients with heart failure compared to mild-to-moderate CKD (stages 1-3)?
Patients with heart failure and advanced CKD (stages 4-5) are older, have more comorbidities, receive less guideline-directed medical therapy, and experience significantly higher 1-year mortality and hospitalization rates than those with mild-to-moderate CKD.
Absolute Event Rate: 36.1% vs 14.6%
p-value: p=<0.001
AIMS: To analyze, in a contemporary registry of patients with heart failure (HF), the differences in characteristics, treatment, and 1-year prognosis between patients with chronic kidney disease (CKD) stages 4-5 versus CKD 1-3. METHODS: We analyzed the SEC-Excelente-HF registry of the Spanish Society of Cardiology, that included 2,245 patients between 2018 and 2023 by 68 HF units. Characteristics, treatment, mortality, and hospitalization rates for HF at 1 year were compared between patients with an estimated glomerular filtration rate (eGFR) < 30 ml/minute/m RESULTS: Of the 2,245 patients, 9.9% had CKD 4-5 and 90.1% had an eGFR ≥ 30 ml/min/m2. Ejection fraction was similar (42.8 ± 15.4 vs. 40.3 ± 15.3%). The CKD 4-5 group was older (76.9 ± 9.6 vs. 70.5 ± 12.4 years; p < 0.001) and showed a higher prevalence of ischemic heart disease, diabetes mellitus, anemia, and iron deficiency. These patients received in a lower proportion all drugs for HF (p < 0.001), except diuretics and potassium binders. Mortality rate (36.1 vs. 14.6/100 person-years; p < 0.001) and the rate of HF hospitalizations at one year (67.3 vs. 30.9/100 person-years; p < 0.001) were higher in patients with CKD stages 4-5. CONCLUSIONS: In a contemporary cohort of patients with HF, patients with CKD stages 4-5 had different clinical characteristics, received in a lesser proportion adequate treatment, and had higher 1-year mortality and HF hospitalization rates.
Anguita-Gámez et al. (Fri,) conducted a cohort in Heart failure (n=2,245). Chronic kidney disease (CKD) stages 4-5 vs. CKD stages 1-3 (eGFR ≥ 30 ml/min/m2) was evaluated on 1-year mortality rate (per 100 person-years) (p=<0.001). Chronic kidney disease stages 4-5 in patients with heart failure was associated with higher 1-year mortality (36.1 vs. 14.6 per 100 person-years; p<0.001) compared to CKD stages 1-3.