Nephron Clinical Practice
Original Paper
Decompensated Heart Failure in the Setting of Kidney Dysfunction: A Community-Wide PerspectiveIsmailov R.M.a · Goldberg R.J.a, b · Lessard D.b · Spencer F.A.b, caDepartment of Community Health, Brown University, Providence, R.I., and bDepartment of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Mass., USA; cDepartment of Medicine, McMaster University, Hamilton, Ont., Canada
Keywords: Heart failureKidney disease |
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Article / Publication Details
Received: March 15, 2007
Accepted: June 21, 2007
Published online: October 22, 2007
Issue release date: January 2008
Number of Print Pages: 1
Number of Figures: 1
Number of Tables: 4
eISSN: 1660-2110 (Online)
For additional information: https://www.karger.com/NEC
Abstract
Background: Patients with heart failure (HF) and kidney disease have a poor long-term outlook which has provided impetus for the identification of factors of prognostic importance and more fully understanding the impact of kidney dysfunction in patients with HF. Objectives: Our objectiveswere to describe the characteristics, hospital treatment practices, as well as hospital and long-term outcomes in patients with varying degrees of kidney dysfunction who were hospitalized with acute HF at all medical centers in a large New England metropolitan area. Methods: Residents of the Worcester metropolitan area hospitalized with clinical findings of decompensated HF at 11 greater Worcester medical centers during 1995 and 2000 comprised the study sample. Kidney function was classified into 4 categories of estimated glomerular filtration rate (eGFR) for purposes of analysis: <30 (n = 569), 30–44 (n = 725), 45–59 (n = 763), and ≧60 (n = 2,293) ml/min per 1.73 m2. Results: The average age of the study sample was 76 years and 57% were women. Patients with severe kidney dysfunction were less likely to receive angiotensin-converting enzyme inhibitors, diuretics and digoxin during hospitalization for acute HF compared to patients with more normal kidney function. Patients with lower eGFR levels had higher in-hospital and post-discharge death rates in comparison to those with higher levels of eGFR. Conclusion: Our results demonstrate the impact of renal impairment on the prognosis of patients with decompensated HF. Our findings highlight the less than optimal management of these high-risk patients. Increased surveillance and enhanced treatment of patients with HF and kidney dysfunction remains warranted to improve the survival outlook of these patients.
© 2007 S. Karger AG, Basel
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Article / Publication Details
Received: March 15, 2007
Accepted: June 21, 2007
Published online: October 22, 2007
Issue release date: January 2008
Number of Print Pages: 1
Number of Figures: 1
Number of Tables: 4
eISSN: 1660-2110 (Online)
For additional information: https://www.karger.com/NEC
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