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Trajectories of Kidney Function in Heart Failure Over a 15-Year Follow-Up: Clinical Profiling and Mortality.
Zamora, Elisabet; Codina, Pau; Aimo, Alberto; Lupón, Josep; Domingo, Mar; Troya, Maribel; Santiago-Vacas, Evelyn; Cediel, Germán; Borrellas, Andrea; Ruiz-Cueto, María; Romero-González, Gregorio A; Santesmases, Javier; Nuñez, Julio; Bover, Jordi; Ara, Jordi; Bayes-Genis, Antoni.
Afiliación
  • Zamora E; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
  • Codina P; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: https://twitter.com/paucodi.
  • Aimo A; Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
  • Lupón J; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
  • Domingo M; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Troya M; Heart Failure Clinic and Nephrology Service, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Santiago-Vacas E; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
  • Cediel G; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
  • Borrellas A; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Ruiz-Cueto M; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Romero-González GA; Heart Failure Clinic and Nephrology Service, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Santesmases J; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Nuñez J; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department, Hospital Clínico Universitario, INCLIVA, València, Spain; Department of Medicine, Universitat de València, València, Spain.
  • Bover J; Heart Failure Clinic and Nephrology Service, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Ara J; Heart Failure Clinic and Nephrology Service, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Bayes-Genis A; Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: abayesgenis@gmail.com.
JACC Heart Fail ; 12(5): 849-859, 2024 May.
Article en En | MEDLINE | ID: mdl-38430086
ABSTRACT

BACKGROUND:

Limited data are available on the long-term trajectory of estimated glomerular filtration rate (eGFR) in patients with chronic heart failure.

OBJECTIVES:

The authors evaluated eGFR dynamics using the 2009 Chronic Kidney Disease Epidemiology Collaboration equation and its prognostic significance in a real-world cohort over a 15-year follow-up.

METHODS:

A prospective observational registry of ambulatory heart failure outpatients was conducted, with regular eGFR assessments at baseline and on a 3-month schedule for ≤15 years. Urgent kidney function assessments were excluded. Locally weighted error sum of squares curves were plotted for predefined subgroups. Multivariable longitudinal Cox regression analyses were conducted to assess associations with all-cause and cardiovascular death.

RESULTS:

A total of 2,672 patients were enrolled consecutively between August 2001 and December 2021. The average age was 66.8 ± 12.6 years, and 69.8% were men. Among 40,970 creatinine measurements, 28,634 were used for eGFR analysis, averaging 10.7 ± 8.5 per patient. Over the study period, a significant decline in eGFR was observed in the entire cohort, with a slope of -1.70 mL/min/1.73 m2 per year (95% CI -1.75 to -1.66 mL/min/1.73 m2 per year). Older patients, those with diabetes, a preserved ejection fraction, a higher baseline eGFR, elevated hospitalization rates, and those who died during follow-up experienced more pronounced decreases in the eGFR. Moreover, the decrease in kidney function correlated independently with all-cause mortality and cardiovascular death.

CONCLUSIONS:

These findings highlight the sustained decline in eGFR over 15 years in patients with heart failure, with variations based on clinical characteristics, and emphasize the importance of regular eGFR monitoring in this population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tasa de Filtración Glomerular / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: JACC Heart Fail Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tasa de Filtración Glomerular / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: JACC Heart Fail Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos