TY - JOUR
T1 - Worsening Renal Function and Prognosis in Heart Failure
T2 - Systematic Review and Meta-Analysis
AU - Damman, Kevin
AU - Navis, Gerjan
AU - Voors, Adriaan A.
AU - Asselbergs, Folkert W.
AU - Smilde, Tom D.J.
AU - Cleland, John G.F.
AU - van Veldhuisen, Dirk J.
AU - Hillege, Hans L.
PY - 2007/10/1
Y1 - 2007/10/1
N2 - Background: Renal impairment is associated with increased mortality in heart failure (HF). Recently, reports suggest that worsening renal function (WRF) is another predictor of clinical outcome in HF. The present study was designed to establish the proportion of patients with HF that exhibits (WRF) and the associated risk for mortality and hospitalization by conducting a systematic review and meta-analysis. Methods and Results: A systematic search of MEDLINE revealed 8 studies on the relationship between WRF and mortality in 18,634 patients with HF. The mortality risk associated with WRF was estimated using random-effects meta-analysis. WRF was defined as an increase in serum creatinine ≥0.2 mg/dL or a corresponding decrease in estimated glomerular filtration rate ≥5 mL·min·1.73 m2. Subgroup analysis included differentiation between in- and out-hospital patients, degree of WRF and time until end point occurrence. WRF developed in 4,734 (25%) patients and was associated with a higher risk for mortality (odds ratio [OR] = 1.62; 95% confidence interval [CI] 1.45-1.82, P < .001) and hospitalization (OR = 1.30, 95% CI 1.04-1.62, P = .022). The severity of WRF was also associated with greater mortality. Patients with impaired renal function at baseline were more prone to progressive renal function loss. Conclusions: WRF predicts substantially higher rates of mortality and hospitalization in patients with HF.
AB - Background: Renal impairment is associated with increased mortality in heart failure (HF). Recently, reports suggest that worsening renal function (WRF) is another predictor of clinical outcome in HF. The present study was designed to establish the proportion of patients with HF that exhibits (WRF) and the associated risk for mortality and hospitalization by conducting a systematic review and meta-analysis. Methods and Results: A systematic search of MEDLINE revealed 8 studies on the relationship between WRF and mortality in 18,634 patients with HF. The mortality risk associated with WRF was estimated using random-effects meta-analysis. WRF was defined as an increase in serum creatinine ≥0.2 mg/dL or a corresponding decrease in estimated glomerular filtration rate ≥5 mL·min·1.73 m2. Subgroup analysis included differentiation between in- and out-hospital patients, degree of WRF and time until end point occurrence. WRF developed in 4,734 (25%) patients and was associated with a higher risk for mortality (odds ratio [OR] = 1.62; 95% confidence interval [CI] 1.45-1.82, P < .001) and hospitalization (OR = 1.30, 95% CI 1.04-1.62, P = .022). The severity of WRF was also associated with greater mortality. Patients with impaired renal function at baseline were more prone to progressive renal function loss. Conclusions: WRF predicts substantially higher rates of mortality and hospitalization in patients with HF.
KW - Heart failure
KW - renal function
KW - worsening renal function
UR - http://www.scopus.com/inward/record.url?scp=34848924327&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2007.04.008
DO - 10.1016/j.cardfail.2007.04.008
M3 - Article
C2 - 17923350
AN - SCOPUS:34848924327
SN - 1071-9164
VL - 13
SP - 599
EP - 608
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 8
ER -