Kevin Damman1, Serge Masson2, Hans L Hillege3, Adriaan A Voors4, Dirk J van Veldhuisen4, Patrick Rossignol5, Gianni Proietti6, Savino Barbuzzi7, Gian Luigi Nicolosi8, Luigi Tavazzi9, Aldo P Maggioni10, Roberto Latini2. 1. Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: k.damman@umcg.nl. 2. Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. 3. Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands. 4. Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 5. INSERM, Centre d'Investigations Cliniques, and Université de Lorraine, INSERM U961, Nancy, France. 6. UO Cardiologia Territoriale, Ospedale di Terni, Terni, Italy. 7. Servizio di Cardiologia, Ospedale di Venosa, Venosa, Italy. 8. Azienda Ospedaliera Santa Maria degli Angeli, UO Cardiologia, Pordenone, Italy. 9. GVM Care and Research, Ettore Sansavini Health Science Foundation-Maria Cecilia Hospital, Cotignola, Italy. 10. ANMCO Research Center, Florence, Italy.
Abstract
OBJECTIVES: This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) in chronic heart failure (HF) BACKGROUND: WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF. METHODS: In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers (N-acetyl-beta-d-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF. RESULTS: A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p < 0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariable-adjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p = 0.001). CONCLUSIONS: WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336).
OBJECTIVES: This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) in chronic heart failure (HF) BACKGROUND: WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF. METHODS: In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers (N-acetyl-beta-d-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF. RESULTS: A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p < 0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariable-adjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p = 0.001). CONCLUSIONS: WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336).
Authors: Ahmad Kaddourah; Stuart L Goldstein; Rajit Basu; Edwards J Nehus; Tara C Terrell; Lori Brunner; Michael R Bennett; Christopher Haffner; John L Jefferies Journal: Pediatr Nephrol Date: 2016-05-02 Impact factor: 3.714
Authors: Alexander R Opotowsky; Fernando R Baraona; Finnian R Mc Causland; Brittani Loukas; Elizabeth Landzberg; Michael J Landzberg; Venkata Sabbisetti; Sushrut S Waikar Journal: Heart Date: 2016-09-26 Impact factor: 5.994