Kevin Damman1, Serge Masson2, Donata Lucci3, Marco Gorini3, Renato Urso4, Aldo P Maggioni3, Luigi Tavazzi5, Luigi Tarantini6, Gianni Tognoni2, Adriaan Voors7, Roberto Latini2. 1. University of Groningen, Department of Cardiology, 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. ANMCO Research Center, Florence, Italy. 4. University of Siena, Siena, Italy. 5. GVM Hospitals of Care and Research, E.S Health Science Foundation, Cotignola, Italy. 6. UOC Cardiologia Azienda ULSS Numero 1, Belluno, Italy. 7. University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: Data on the natural change in renal function in patients with chronic heart failure (HF) are limited. METHODS AND RESULTS:Estimated glomerular filtration rate (eGFR) was assessed over 36 months in 6934 patients included in the GISSI-HF study. Associations from baseline, changes in renal function, and occurrence of cardiovascular death or HF hospitalization were assessed. Mean age was 67 years, mainly men (78%), and mean eGFR was 68 mL • min-1 • 1.73 m-2. Change in eGFR in the 1st year was -1.5 ± 16 mL • min-1 • 1.73 m-2, and over 36 months it was -3.7 ± 18 mL • min-1 • 1.73 m-2. Over the latter period, only 25% deteriorated ≥1 Kidney Disease Outcomes Quality Initiatives (KDOQI) class of chronic kidney disease (CKD). Fifteen percent of patients had >15 mL • min-1 • 1.73 m-2 decrease in eGFR in the 1st 12 months. Lower eGFR was associated with outcome: hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.08-1.10 (P < .001) per 10 mL • min-1 • 1.73 m-2 decrease, as well as every 10 mL • min-1 • 1.73 m-2 decrease over the 1st year (HR 1.10, 95% CI 1.04-1.17; P < .001). A deterioration in eGFR >15 mL • min-1 • 1.73 m-2 in the 1st year showed the highest risk of events (HR 1.22, 95% CI 1.10-1.36; P < .001). CONCLUSIONS: Mean decrease in renal function over time in patients with chronic HF was modest. Only 25% deteriorated ≥1 KDOQI class of CKD after 3 years. Any decrease in eGFR over time was associated with strongly increased event rates.
RCT Entities:
BACKGROUND: Data on the natural change in renal function in patients with chronic heart failure (HF) are limited. METHODS AND RESULTS: Estimated glomerular filtration rate (eGFR) was assessed over 36 months in 6934 patients included in the GISSI-HF study. Associations from baseline, changes in renal function, and occurrence of cardiovascular death or HF hospitalization were assessed. Mean age was 67 years, mainly men (78%), and mean eGFR was 68 mL • min-1 • 1.73 m-2. Change in eGFR in the 1st year was -1.5 ± 16 mL • min-1 • 1.73 m-2, and over 36 months it was -3.7 ± 18 mL • min-1 • 1.73 m-2. Over the latter period, only 25% deteriorated ≥1 Kidney Disease Outcomes Quality Initiatives (KDOQI) class of chronic kidney disease (CKD). Fifteen percent of patients had >15 mL • min-1 • 1.73 m-2 decrease in eGFR in the 1st 12 months. Lower eGFR was associated with outcome: hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.08-1.10 (P < .001) per 10 mL • min-1 • 1.73 m-2 decrease, as well as every 10 mL • min-1 • 1.73 m-2 decrease over the 1st year (HR 1.10, 95% CI 1.04-1.17; P < .001). A deterioration in eGFR >15 mL • min-1 • 1.73 m-2 in the 1st year showed the highest risk of events (HR 1.22, 95% CI 1.10-1.36; P < .001). CONCLUSIONS: Mean decrease in renal function over time in patients with chronic HF was modest. Only 25% deteriorated ≥1 KDOQI class of CKD after 3 years. Any decrease in eGFR over time was associated with strongly increased event rates.
Authors: Meaghan Lunney; Marinella Ruospo; Patrizia Natale; Robert R Quinn; Paul E Ronksley; Ioannis Konstantinidis; Suetonia C Palmer; Marcello Tonelli; Giovanni Fm Strippoli; Pietro Ravani Journal: Cochrane Database Syst Rev Date: 2020-02-27
Authors: Pardeep S Jhund; Scott D Solomon; Kieran F Docherty; Hiddo J L Heerspink; Inder S Anand; Michael Böhm; Vijay Chopra; Rudolf A de Boer; Akshay S Desai; Junbo Ge; Masafumi Kitakaze; Bela Merkley; Eileen O'Meara; Morten Shou; Sergey Tereshchenko; Subodh Verma; Pham Nguyen Vinh; Silvio E Inzucchi; Lars Køber; Mikhail N Kosiborod; Felipe A Martinez; Piotr Ponikowski; Marc S Sabatine; Olof Bengtsson; Anna Maria Langkilde; Mikaela Sjöstrand; John J V McMurray Journal: Circulation Date: 2020-10-12 Impact factor: 29.690