Decongestion, kidney injury and prognosis in patients with acute heart failure

Autor: Yu, Horiuchi, Nicholas, Wettersten, Dirk J, van Veldhuisen, Christian, Mueller, Gerasimos, Filippatos, Richard, Nowak, Christopher, Hogan, Michael C, Kontos, Chad M, Cannon, Gerhard A, Müeller, Robert, Birkhahn, Pam, Taub, Gary M, Vilke, Olga, Barnett, Kenneth, McDonald, Niall, Mahon, Julio, Nuñez, Carlo, Briguori, Claudio, Passino, Stephen, Duff, Alan, Maisel, Patrick T, Murray
Přispěvatelé: Cardiovascular Centre (CVC)
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Journal of Cardiology, 354, 29-37. ELSEVIER IRELAND LTD
INTERNATIONAL JOURNAL OF CARDIOLOGY
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname
ISSN: 1874-1754
0167-5273
Popis: BACKGROUND: In patients with acute heart failure (AHF), the development of worsening renal function with appropriate decongestion is thought to be a benign functional change and not associated with poor prognosis. We investigated whether the benefit of decongestion outweighs the risk of concurrent kidney tubular damage and leads to better outcomes.; METHODS: We retrospectively analyzed data from the AKINESIS study, which enrolled AHF patients requiring intravenous diuretic therapy. Urine neutrophil gelatinase-associated lipocalin (uNGAL) and B-type natriuretic peptide (BNP) were serially measured during the hospitalization. Decongestion was defined as =30% BNP decrease at discharge compared to admission. Univariable and multivariable Cox models were assessed for one-year mortality.; RESULTS: Among 736 patients, 53% had =30% BNP decrease at discharge. Levels of uNGAL and BNP at each collection time point had positive but weak correlations (r=0.133). Patients without decongestion and with higher discharge uNGAL values had worse one-year mortality, while those with decongestion had better outcomes regardless of uNGAL values (p for interaction 0.018). This interaction was also significant when the change in BNP was analyzed as a continuous variable (p
Databáze: OpenAIRE
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