scholarly journals Inhospital mortality of patients with left ventricle dysfunction admitted with acute decompensated heart failure: the role of renal function during hospitalization

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 3) ◽  
pp. P30
Author(s):  
S Mangini ◽  
A Abuhab ◽  
AG Correa ◽  
PKO Yokota ◽  
LF Lisboa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Left Ventricle ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Inhospital Mortality ◽  
Left Ventricle Dysfunction

scholarly journals Therapeutic Options for the Management of the Cardiorenal Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Katerina Koniari ◽  
Marinos Nikolaou ◽  
Ioannis Paraskevaidis ◽  
John Parissis
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Decompensated Heart Failure ◽  
Clinical Success ◽  
Decompensated Heart Failure ◽  
Cardiorenal Syndrome ◽  
Patients With Heart Failure ◽  
Adenosine A1 ◽  
A1 Receptor

Patients with heart failure often present with impaired renal function, which is a predictor of poor outcome. The cardiorenal syndrome is the worsening of renal function, which is accelerated by worsening of heart failure or acute decompensated heart failure. Although it is a frequent clinical entity due to the improved survival of heart failure patients, still its pathophysiology is not well understood, and thus its therapeutic approach remains controversial and sometimes ineffective. Established therapeutic strategies, such as diuretics and inotropes, are often associated with resistance and limited clinical success. That leads to an increasing concern about novel options, such as the use of vasopressin antagonists, adenosine A1 receptor antagonists, and renal-protective dopamine. Initial clinical trials have shown quite encouraging results in some heart failure subpopulations but have failed to demonstrate a clear beneficial role of these agents. On the other hand, ultrafiltration appears to be a more promising therapeutic procedure that will improve volume regulation, while preserving renal and cardiac function. Further clinical studies are required in order to determine their net effect on renal function and potential cardiovascular outcomes. Until then, management of the cardiorenal syndrome remains quite empirical.

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).

4877Renal function and intensive blood pressure lowering in high-risk adults without diabetes: insights from the Systolic Blood Pressure Intervention Trial (SPRINT)

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Pareek ◽  
A M D Kristensen ◽  
M Vaduganathan ◽  
T Biering-Sorensen ◽  
C Byrne ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Renal Function ◽  
Acute Decompensated Heart Failure ◽  
Kidney Injury ◽  
Decompensated Heart Failure ◽  
Primary Efficacy ◽  
Primary Efficacy Endpoint ◽  
The Relationship ◽  
Intensive Blood Pressure

Abstract Background The Systolic Blood Pressure Intervention Trial (SPRINT) found that intensive blood pressure (BP) lowering reduced the rates of cardiovascular events and mortality but increased the risk of certain adverse events, in patients with and without chronic kidney disease at baseline. However, it is unclear whether intensive BP management is well-tolerated and modifies risk uniformly across the entire spectrum of renal function. Purpose To assess the relationship between renal function, treatment response to intensive BP lowering, and cardiovascular (CV) outcomes. Methods SPRINT was a randomized, controlled trial in which 9,361 individuals ≥50 years of age, at high CV risk but without diabetes who had a systolic BP (SBP) 130–180 mmHg, were randomized to intensive (target SBP <120mmHg) or standard antihypertensive treatment (target SBP <140mmHg). The primary efficacy endpoint was the composite of acute coronary syndromes, stroke, acute decompensated heart failure, or death from CV causes. The primary safety endpoint was the composite of serious adverse events (SAE). Renal function was assessed using the estimated glomerular filtration rate (GFR), calculated with the Modification of Diet in Renal Disease equation. We first assessed whether a linear association was present between eGFR and clinical endpoints using restricted cubic splines. We then examined the prognostic implications of eGFR, unadjusted and adjusted for demographic, clinical, and laboratory variables. We further explored the effects of intensive BP lowering across the eGFR spectrum. Results Baseline eGFR was available for 9,324 (>99%) individuals. Mean eGFR was similar between the two groups (intensive group 71.8 ml/min/1.73m2 vs. standard group 71.7 ml/min/1.73m2; P=0.92). Median follow-up was 3.3 years (range 0–4.8), with 561 primary efficacy events (6%) and 3,522 SAE (38%) recorded during the study period. Baseline eGFR was non-linearly associated with the risk of the primary efficacy endpoint, death from CV causes, death from any cause, acute decompensated heart failure, SAE, electrolyte abnormality, and acute kidney injury (test for non-linearity, P<0.05; test for overall trend, P<0.001) and remained significantly associated with all tested endpoints upon multivariable adjustment (P<0.05). Baseline eGFR significantly modified the effects of intensive BP lowering on the primary efficacy endpoint (P=0.02), acute decompensated heart failure (P=0.01), SAE (P=0.01), and acute kidney injury (P=0.04). The Figure shows treatment effects (hazard ratios) across the spectrum of eGFR for these four endpoints. P-values are for the interaction between eGFR and treatment effect. Significant interactions were not detected for other endpoints. Figure 1 Conclusions In SPRINT, lower eGFR was associated with a greater risk of both CV events and SAE. Patients with higher eGFR appeared to derive more benefit from intensive BP lowering while the relationship with safety events was complex.

scholarly journals New renal haemodynamic indices can predict worsening of renal function in acute decompensated heart failure

2020 ◽  
Vol 7 (5) ◽  
pp. 2581-2588
Author(s):  
Amir Mostafa ◽  
Karim Said ◽  
Walid Ammar ◽  
Ahmed Elsayed Eltawil ◽  
Magdy Abdelhamid
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure

Renal Function in Patients With Acute Decompensated Heart Failure Treated With Ultrafiltration

2012 ◽  
Vol 18 (8) ◽  
pp. S74
Author(s):  
Nicholas Haglund ◽  
Michael Johnston ◽  
Ioana Dumitru ◽  
Joan Mack ◽  
Brian Lowes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure

scholarly journals IMPACT OF LEVOSIMENDAN ON RENAL FUNCTION IN COMPLEX TREATMENT OF ACUTE DECOMPENSATED HEART FAILURE

2018 ◽  
Vol 14 (2) ◽  
pp. 176-183
Author(s):  
M. V. Lediakhova ◽  
S. N. Nasonova ◽  
I. V. Zhirov ◽  
M. V. Andreevskaya ◽  
R. M. Bogieva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Complex Treatment
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