High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database.

By J. Heywood, G. Fonarow, M. Costanzo, Vandana S. Mathur, John Wigneswaran, Janet Wynne. Journal of Cardiac Failure, 2007

802 citations recorded by the source corpus.

BACKGROUND The prevalence of renal dysfunction in patients hospitalized with acute decompensated heart failure remains poorly characterized. METHODS AND RESULTS Data from 118,465 hospitalization episodes were evaluated. Glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease formula. At admission, 10,660 patients (9.0%) had normal renal function (GFR > or = 90 mL x min x 1.73 m2), 32,423 patients (27.4%) had mild renal dysfunction (GFR 60-89 mL x min x 1.73 m2), 51,553 patients (43.5%) had moderate renal dysfunction (GFR 30-59 mL.min.1.73 m2), 15,553 patients (13.1%) had severe renal dysfunction (GFR 15-29 mL x min x 1.73 m2), and 8276 patients (7.0%) had kidney failure (GFR < 15 mL x min x 1.73 m2 or chronic dialysis). Despite this, only 33.4% of men and 27.3% of women were diagnosed with renal insufficiency. Diuretic dose, inotrope use, and nesiritide use increased, whereas angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker use decreased, with increasing renal dysfunction (all P < .0001 across stages). In-hospital mortality increased from 1.9% for patients with normal renal function to 7.6% and 6.5% for patients with severe dysfunction and kidney failure, respectively (P < .0001). CONCLUSIONS The majority of patients admitted with acute decompensated heart failure have significant renal impairment, which influences treatment and outcomes.

Subfields: Cardiology and Cardiovascular Medicine, Nephrology

View Paper: https://www.semanticscholar.org/paper/75e62fedd7e1fc66a0878b8cdb04b99505bacf83

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Cardiology and Cardiovascular Medicine

1. M. Gheorghiade
2. S. Anker
3. G. Fonarow

In Nephrology

1. Sean M. Bagshaw
2. Claudio Ronco
3. R. Bellomo
4. M. Gheorghiade
5. John A. Kellum

Citations in the corpus

• Cardio-renal syndromes: report from the consensus conference of the Acute Dialysis Quality Initiative (2009, background): “Nevertheless, between 45 and 63.6% of patients with CHF have evidence of CKD.11,27 In these studies, CKD was associated with higher all-cause and cardiac-specific mortality.”
• The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. (2014, background): “, blood urea nitrogen and serum creatinine) (42,69), serum sodium (41), hemoglobin (40), NP concentration (70,71), troponin (71,72), QRS duration (43,71), and evidence-based medication utilization (73,74).”
• Acute heart failure syndromes (2009, background): “Renal impairment is often present at ime of admission (22).”