INTRODUCTION: Heart failure (HF) and chronic kidney disease (CKD) share many risk factors, and cardiac and renal dysfunction often coexist. The close association between HF and CKD worsens patient prognosis. OBJECTIVE: To examine the association between progressing CKD with rates of hospitalization, 30-day readmission, and mortality in patients with HF. METHODS: A retrospective analysis was conducted from January 1, 2012, to December 31, 2016, in the Kaiser Permanente Southern California Region. All patients age 18 years or older with a diagnosis of comorbid CKD and HF were included. Patients were excluded if they were noncontinuous members of Kaiser Permanente. Those included in the study were stratified into 2 cohorts: Early-stage CKD (stages 1, 2, and 3) and late-stage CKD (stages 4 and 5) on the basis of their estimated glomerular filtration rate in accordance with the National Kidney Foundation. RESULTS: A total of 27,366 patients were identified with comorbid HF and CKD. At the first year of follow-up, patients with HF and late-stage CKD had higher all-cause hospitalization (rate ratio [RR] = 1.56, 95% confidence interval [CI] = 1.48-1.65, p < 0.001), HF-related hospitalization (RR = 1.25, 95% CI = 1.20-1.41, p = 0.001), and 30-day readmission rates (RR = 1.46, 95% CI = 1.31-1.63, p < 0.001) compared with patients with HF and early-stage CKD. In subsequent follow-up years, patients continued to have higher all-cause and HF-related hospitalization rates in late-stage CKD. The late-stage CKD cohort had a significantly higher risk of 5-year mortality (hazard ratio = 1.40, 95% CI = 1.35-1.45, p < 0.001). CONCLUSION: Stage 4 and 5 CKD is a significant contributor to poor prognosis in patients with HF, leading to significantly higher rates of hospitalization, 30-day readmission, and mortality.
INTRODUCTION:Heart failure (HF) and chronic kidney disease (CKD) share many risk factors, and cardiac and renal dysfunction often coexist. The close association between HF and CKD worsens patient prognosis. OBJECTIVE: To examine the association between progressing CKD with rates of hospitalization, 30-day readmission, and mortality in patients with HF. METHODS: A retrospective analysis was conducted from January 1, 2012, to December 31, 2016, in the Kaiser Permanente Southern California Region. All patients age 18 years or older with a diagnosis of comorbid CKD and HF were included. Patients were excluded if they were noncontinuous members of Kaiser Permanente. Those included in the study were stratified into 2 cohorts: Early-stage CKD (stages 1, 2, and 3) and late-stage CKD (stages 4 and 5) on the basis of their estimated glomerular filtration rate in accordance with the National Kidney Foundation. RESULTS: A total of 27,366 patients were identified with comorbid HF and CKD. At the first year of follow-up, patients with HF and late-stage CKD had higher all-cause hospitalization (rate ratio [RR] = 1.56, 95% confidence interval [CI] = 1.48-1.65, p < 0.001), HF-related hospitalization (RR = 1.25, 95% CI = 1.20-1.41, p = 0.001), and 30-day readmission rates (RR = 1.46, 95% CI = 1.31-1.63, p < 0.001) compared with patients with HF and early-stage CKD. In subsequent follow-up years, patients continued to have higher all-cause and HF-related hospitalization rates in late-stage CKD. The late-stage CKD cohort had a significantly higher risk of 5-year mortality (hazard ratio = 1.40, 95% CI = 1.35-1.45, p < 0.001). CONCLUSION: Stage 4 and 5 CKD is a significant contributor to poor prognosis in patients with HF, leading to significantly higher rates of hospitalization, 30-day readmission, and mortality.
Authors: Alanna M Chamberlain; Margaret M Redfield; Alvaro Alonso; Susan A Weston; Véronique L Roger Journal: Circ Heart Fail Date: 2011-09-15 Impact factor: 8.790
Authors: Aminu K Bello; Brenda Hemmelgarn; Anita Lloyd; Matthew T James; Braden J Manns; Scott Klarenbach; Marcello Tonelli Journal: Clin J Am Soc Nephrol Date: 2011-04-28 Impact factor: 8.237
Authors: Jason P Swindle; Wing W Chan; Katherine Waltman Johnson; Laura Becker; Cori Blauer-Peterson; Aylin Altan Journal: Curr Med Res Opin Date: 2016-08-02 Impact factor: 2.580
Authors: Arise G S Galil; Hélady S Pinheiro; Alfredo Chaoubah; Darcília M N Costa; Marcus G Bastos Journal: BMC Nephrol Date: 2009-10-21 Impact factor: 2.388
Authors: Louise Roy; Michael Zappitelli; Brian White-Guay; Jean-Philippe Lafrance; Marc Dorais; Sylvie Perreault Journal: Can J Kidney Health Dis Date: 2020-10-10