Is Worsening Renal Function Relevant without Clinical Context?

2021 ◽  
Author(s):  
Haider J Warraich ◽  
Anju Nohria
Keyword(s):  
Renal Function ◽  
Clinical Context ◽  
Worsening Renal Function

scholarly journals Any heart failure treatments associated with worsening renal function in patients admitted due to acute heart failure?

Renal Failure ◽  
2021 ◽  
Vol 43 (1) ◽  
pp. 123-127
Author(s):  
Chutatip Limkunakul ◽  
Benjawan Srisantithum ◽  
Yotin Lerdrattanasakulchai ◽  
Thanakorn Laksomya ◽  
Jatuphorn Jungpanich ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Heart Failure ◽  
Worsening Renal Function

Worsening Renal Function during Index Hospitalization Does Not Predict Prognosis in Heart Failure with Preserved Ejection Fraction Patients

Cardiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Ravi Rasalingam ◽  
Rachel Parker ◽  
Katherine E. Kurgansky ◽  
Luc Djousse ◽  
David Gagnon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Incidence Density ◽  
Preserved Ejection Fraction ◽  
Index Hospitalization ◽  
Risk Of Death ◽  
Worsening Renal Function ◽  
Group 1

<b><i>Introduction:</i></b> Worsening renal function (WRF) predicts poor prognosis in patients with left ventricular systolic dysfunction. The effect of WRF in heart failure with preserved ejection fraction (HFpEF) is unclear. <b><i>Objective:</i></b> The objective of this study was to determine whether WRF during index hospitalization for HFpEF is associated with increased death or readmission for heart failure. <b><i>Methods:</i></b> National Veterans Affairs electronic medical data recorded between January 1, 2002, and December 31, 2014, were screened to identify index hospitalizations for HFpEF using an iterative algorithm. Patients were divided into 3 groups based on changes in serum Cr (sCr) during this admission. WRF was defined as a rise in sCr ≥0.3 mg/dL. Group 1 had no evidence of WRF, group 2 had transient WRF, and group 3 had persistent WRF at the time of discharge. <b><i>Results:</i></b> A total of 10,902 patients with index hospitalizations for HFpEF were identified (mean age 72, 97% male). Twenty-nine percent had WRF during this hospital admission, with 48% showing recovery of sCr and 52% with no recovery at discharge. The mortality rate over a mean follow-up duration of 3.26 years was 72%. Compared to group 1, groups 2 and 3 showed no significant difference in risk of death from any cause (hazard ratio [HR] = 0.95 [95% confidence interval [CI]: 0.87, 1.03] and 1.02 [95% CI: 0.93, 1.11], respectively), days hospitalized for any cause (incidence density ratio [IDR] = 1.01 [95% CI: 0.92, 1.11] and 1.01 [95% CI: 0.93, 1.11], respectively), or days hospitalized for heart failure (IDR = 0.94 [95% CI: 0.80, 1.10] and 0.94 [95% CI: 0.81, 1.09], respectively) in analyses adjusted for covariates affecting renal function and outcomes. <b><i>Conclusions:</i></b> While there is a high incidence of WRF during index hospitalizations for HFpEF, WRF is not associated with an increased risk of death or hospitalization. This suggests that WRF alone should not influence decisions regarding heart failure management.

scholarly journals Adverse outcomes after worsening renal function in patients with atrial fibrillation: the Fushimi AF Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Ogawa ◽  
Y An ◽  
S Ikeda ◽  
Y Aono ◽  
K Doi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Renal Function ◽  
Oral Anticoagulants ◽  
Adverse Outcomes ◽  
Funding Source ◽  
Worsening Renal Function ◽  
Gault Formula ◽  
Bayer Healthcare ◽  
Artery Disease

Abstract Background Patients with atrial fibrillation (AF) commonly coexist with chronic kidney disease (CKD). Non-vitamin K antagonist oral anticoagulants (NOAC) are recommended for stroke prevention in patients with non-valvular atrial fibrillation (AF), and worsening renal function (WRF) as well as CKD is an important issue in using NOAC. However, little is known about the clinical outcomes of patients after WRF. Purpose We aimed to investigate outcomes after WRF in AF patients. Methods The Fushimi AF Registry is a community-based prospective survey of the AF patients in our city. Follow-up data including prescription status were available for 4,441 patients. Of them, 1,890 patients who have baseline and at least 1 follow-up creatinine clearance (CrCl) measurements, estimated by the Cockcroft-Gault formula, were analyzed in the present study. WRF was defined as a decrease of ≥20% from baseline CrCl measurement at any time point during follow-up. We evaluated demographics and outcomes after WRF in AF patients. Results During the median follow-up period of 2,194 days, mean CrCl decrease of 2.2 ml/min/year was observed and WRF occurred in 981 patients (51.9%). Patients with WRF were significantly more often female (with vs. without WRF; 40.3% vs. 35.4%; p=0.03), older (73.4 vs. 71.1 years of age; p&lt;0.01), more often paroxysmal type (49.9% vs. 47.1%; p&lt;0.01), and more likely to have prior stroke (17.9% vs. 12.7%; p&lt;0.01), heart failure (30.8% vs. 24.8%; p&lt;0.01), diabetes (31.7% vs. 27.1%; p=0.03), and coronary artery disease (19.9% vs. 12.1%; p&lt;0.01) than those without WRF. Co-existing of CKD and mean CrCl at baseline were comparable (37.4% vs. 36.9%; p=0.82, 65.3 vs. 63.5 ml/min; p=0.66, respectively). Mean CHA2DS2-VASc score was significantly higher in WRF patients (3.55 vs. 3.03; p&lt;0.01). On landmark analysis, all-cause mortality occurred in 135 patients (8.6 /100 person-years) after WRF and 82 patients (1.7 /100 person-years) without WRF, with an adjusted hazard ratio (HR) of 6.33 (95% confidence interval [CI], 4.33–9.50; p&lt;0.01), adjusted by sex, age, body weight, serum creatinine, type of AF, oral anticoagulant prescription and comorbidities. Stroke or systemic embolism occurred in 45 patients after WRF (3.0 /100 person-years) and 78 (1.7 /100 person-years) patients without WRF (adjusted HR 1.60 [95% CI, 1.04–2.49; p=0.03]) (Figure). Conclusions AF patients after WRF had higher incidence of various adverse events. Incidence of Adverse Outcomes Funding Acknowledgement Type of funding source: Other. Main funding source(s): The Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus from Japan Agency for Medical Research and Development. Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi-Sankyo, Novartis Pharma, MSD, Sanofi-Aventis, and Takeda Pharmaceutical.

Altered fibrin clot structure in patients with atrial fibrillation and worsening renal function

2016 ◽  
Vol 116 (09) ◽  
pp. 408-409 ◽  
Author(s):  
Helen Philippou ◽  
Andrew D. Blann ◽  
Yee Cheng Lau ◽  
Lewis J. Hardy ◽  
Gregory Y. H. Lip
Keyword(s):  
Atrial Fibrillation ◽  
Renal Function ◽  
Review Process ◽  
Fibrin Clot ◽  
Worsening Renal Function ◽  
Clot Structure

Note: The review process for this manuscript was fully handled by Christian Weber, Editor in Chief.

scholarly journals Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis

2013 ◽  
Vol 35 (7) ◽  
pp. 455-469 ◽  
Author(s):  
K. Damman ◽  
M. A. E. Valente ◽  
A. A. Voors ◽  
C. M. O'Connor ◽  
D. J. van Veldhuisen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Renal Impairment ◽  
Meta Analysis ◽  
Worsening Renal Function ◽  
Patients With Heart Failure

scholarly journals Comparison between admission natriuretic peptides, NGAL and sST2 testing for the prediction of worsening renal function in patients with acutely decompensated heart failure

2015 ◽  
Vol 53 (4) ◽  
Author(s):  
Benedetta De Berardinis ◽  
Hanna K. Gaggin ◽  
Laura Magrini ◽  
Arianna Belcher ◽  
Benedetta Zancla ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Natriuretic Peptide ◽  
Acute Decompensated Heart Failure ◽  
International Study ◽  
Decompensated Heart Failure ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Amino Terminal ◽  
Worsening Renal Function

AbstractIn order to predict the occurrence of worsening renal function (WRF) and of WRF plus in-hospital death, 101 emergency department (ED) patients with acute decompensated heart failure (ADHF) were evaluated with testing for amino-terminal pro-B-type natriuretic peptide (NT-proBNP), BNP, sST2, and neutrophil gelatinase associated lipocalin (NGAL).In a prospective international study, biomarkers were collected at the time of admission; the occurrence of subsequent in hospital WRF was evaluated.In total 26% of patients developed WRF. Compared to patients without WRF, those with WRF had a longer in-hospital length of stay (LOS) (mean LOS 13.1±13.4 days vs. 4.8±3.7 days, p<0.001) and higher in-hospital mortality [6/26 (23%) vs. 2/75 (2.6%), p<0.001]. Among the biomarkers assessed, baseline NT-proBNP (4846 vs. 3024 pg/mL; p=0.04), BNP (609 vs. 435 pg/mL; p=0.05) and NGAL (234 vs. 174 pg/mL; p=0.05) were each higher in those who developed WRF. In logistic regression, the combination of elevated natriuretic peptide and NGAL were additively predictive for WRF (OR: In ED patients with ADHF, the combination of NT-proBNP or BNP plus NGAL at presentation may be useful to predict impending WRF (Clinicaltrials.gov NCT#0150153).

Right atrial pressure predicts worsening renal function in patients with acute right ventricular myocardial infarction

2018 ◽  
Vol 264 ◽  
pp. 25-27 ◽  
Author(s):  
Juan Betuel Ivey-Miranda ◽  
Edith Liliana Posada-Martínez ◽  
Eduardo Almeida-Gutiérrez ◽  
Gabriela Borrayo-Sánchez ◽  
Eduardo Flores-Umanzor
Keyword(s):  
Myocardial Infarction ◽  
Renal Function ◽  
Right Ventricular ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Worsening Renal Function ◽  
Right Ventricular Myocardial Infarction

scholarly journals The Renal Effects of Aggressive Volume Removal in Heart Failure Patients with Preexisting Worsening Renal Function

2018 ◽  
Vol 24 (8) ◽  
pp. S26
Author(s):  
Devin Mahoney ◽  
Tariq Ahmad ◽  
Veena Rao ◽  
Meredith Brisco-Bacik ◽  
F. Perry Wilson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Renal Effects ◽  
Heart Failure Patients ◽  
Worsening Renal Function
Sign in / Sign up

Export Citation Format

Share Document