Baseline and worsening renal function over 6 months predicted higher mortality in CHF patients (P<0.001), whereas improved renal function predicted lower mortality (HR 0.8; 95% CI 0.6-1.0).
Cohort (n=1,216)
What is the incidence of worsening renal function and its impact on mortality in patients with chronic heart failure?
In patients with chronic heart failure, renal dysfunction is common, frequently worsens over 6 months, and both baseline and worsening renal function strongly predict higher mortality.
Effect estimate: HR 0.8 (95% CI 0.6-1.0)
p-value: p=<0.001
AIMS: To determine the prevalence and incidence of renal dysfunction (RD) in patients with chronic heart failure (CHF), to identify contributory factors and predictors of worsening renal function (WRF), and to explore the relationship between RD and mortality. METHODS AND RESULTS: Prospective data on 1216 patients with CHF were analysed. The glomerular filtration rate (GFR) was used to determine renal function, and WRF was defined as an increase in serum creatinine of >26.5 micromol/L (>0.3 mg/dL). The prevalence of RD defined as a GFR of 9 mmol/L. Two hundred and sixty-three (21.6%) patients died, and baseline RD and WRF both predicted a higher mortality (P<0.001), whereas an improvement in renal function over the first 6 months predicted a lower mortality (hazard ratio 0.8, 95% confidence interval 0.6-1.0). CONCLUSION: In ambulatory patients with CHF, RD is common, commonly deteriorates over a relatively short period of time, is unlikely to recover substantially, and augurs a poor prognosis.
Silva et al. (2005) conducted a cohort in Chronic heart failure due to left ventricular systolic dysfunction (n=1,216). Baseline renal dysfunction and worsening renal function vs. Normal or improving renal function was evaluated on Mortality (HR 0.8, 95% CI 0.6-1.0, p=<0.001). Baseline and worsening renal function over 6 months predicted higher mortality in CHF patients (P<0.001), whereas improved renal function predicted lower mortality (HR 0.8; 95% CI 0.6-1.0).