Renal dysfunction in African patients with acute heart failure

Autor: Dike B. Ojji, Karen Sliwa, Albertino Damasceno, Bongani M. Mayosi, Licette C. Y. Liu, Christopher L. Edwards, A. A. Voors, Mahmoud U Sani, Gad Cotter, Okechukwu S Ogah, Beth A. Davison, Charles Mondo, Anastase Dzudie
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Male
IMPACT
Myocardial Ischemia
Worsening renal function
Disease
urologic and male genital diseases
CENTRAL VENOUS-PRESSURE
chemistry.chemical_compound
HOSPITALIZED-PATIENTS
LONG-TERM OUTCOMES
Renal Insufficiency
Outcome
Hazard ratio
Central venous pressure
Middle Aged
IMPAIRMENT
Prognosis
ADMISSION
Creatinine
Acute Disease
Hypertension
Cardiology
Disease Progression
Renal dysfunction
Female
Cardiology and Cardiovascular Medicine
Glomerular Filtration Rate
Adult
medicine.medical_specialty
Black african
Renal function
Black People
Patient Readmission
Internal medicine
ONE-YEAR MORTALITY
medicine
Humans
Intensive care medicine
Africa South of the Sahara
METAANALYSIS
Aged
Proportional Hazards Models
Heart Failure
business.industry
medicine.disease
chemistry
Heart failure
REGISTRY
Africa
SYSTOLIC DYSFUNCTION
business
Body mass index
Zdroj: European Journal of Heart Failure, 16(7), 718-728. Wiley
ISSN: 1879-0844
1388-9842
Popis: Aims In Western countries with typically elderly ischaemic acute heart failure patients, predictors and clinical outcome of renal dysfunction and worsening renal function are well described. However, the prevalence, predictors and clinical outcome of renal dysfunction in younger, mainly hypertensive acute heart failure patients from Africa, have not been described. Methods and results From 1006 patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF), renal function was determined by the estimated glomerular filtration rate using the Modification of Diet in Renal Disease (MDRD) formula. Worsening renal function was defined as an increase in creatinine ≤0.3 mg/dL (26.5 µmol/L) from baseline to day 7/discharge. The mean (SD) age of the patients was 52.4 (18.2) years, 481 (50.8%) were women and the predominant race was black African [932 of 946 (98.5%)]. Heart failure was most commonly a result of hypertension (n = 363, 39.5%) and only 7.8% had ischaemic heart failure. At hospital admission, 289 patients (30.6%) had an estimated glomerular filtration rate ≤60 ml/min.1.73m2. Worsening renal function during hospitalization was detected in 53 (9.8 %) of 543 patients with a follow-up creatinine value, and was independently associated with the Western sub-Saharan region, body mass index, and the presence of rales. Worsening renal function was an independent predictor of death or readmission over 60 days [multivariable hazard ratio = 2.06 (1.10, 3.38); P = 0.023] and all-cause death over 180 days [multivariable hazard ratio =1.92 (1.08, 3.38); P = 0.025]. Conclusions Renal dysfunction is also prevalent in younger non-ischaemic acute heart failure patients in Africa, but worsening renal function is less prevalent and has different predictors compared with Western cohorts. Nevertheless, worsening renal function is strongly and independently related with clinical outcome.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje