Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance.
<h4>Background</h4>Kidney dysfunction is prevalent and impacts prognosis in patients with acute decompensated heart failure (ADHF). However, most previous reports were from a single hospital, limiting their generalizability. Also, contemporary data using new equation for estimated glomer...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181373&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850230559611027456 |
|---|---|
| author | Kunihiro Matsushita Lucia Kwak Noorie Hyun Marina Bessel Sunil K Agarwal Laura R Loehr Hanyu Ni Patricia P Chang Josef Coresh Lisa M Wruck Wayne Rosamond |
| author_facet | Kunihiro Matsushita Lucia Kwak Noorie Hyun Marina Bessel Sunil K Agarwal Laura R Loehr Hanyu Ni Patricia P Chang Josef Coresh Lisa M Wruck Wayne Rosamond |
| author_sort | Kunihiro Matsushita |
| collection | DOAJ |
| description | <h4>Background</h4>Kidney dysfunction is prevalent and impacts prognosis in patients with acute decompensated heart failure (ADHF). However, most previous reports were from a single hospital, limiting their generalizability. Also, contemporary data using new equation for estimated glomerular filtration rate (eGFR) are needed.<h4>Methods and results</h4>We analyzed data from the ARIC Community Surveillance for ADHF conducted for residents aged ≥55 years in four US communities between 2005-2011. All ADHF cases (n = 5, 391) were adjudicated and weighted to represent those communities (24,932 weighted cases). The association of kidney function (creatinine-based eGFR by the CKD-EPI equation and blood urea nitrogen [BUN]) during hospitalization with 1-year mortality was assessed using logistic regression. Based on worst and last serum creatinine, there were 82.5% and 70.6% with reduced eGFR (<60 ml/min/1.73m2) and 37.4% and 26.6% with severely reduced eGFR (<30 ml/min/1.73m2), respectively. Lower eGFR (regardless of last or worst eGFR), particularly eGFR <30 ml/min/1.73m2, was significantly associated with higher 1-year mortality independently of potential confounders (odds ratio 1.60 [95% CI 1.26-2.04] for last eGFR 15-29 ml/min/1.73m2 and 2.30 [1.76-3.00] for <15 compared to eGFR ≥60). The association was largely consistent across demographic subgroups. Of interest, when both eGFR and BUN were modeled together, only BUN remained significant.<h4>Conclusions</h4>Severely reduced eGFR (<30 ml/min/1.73m2) was observed in ~30% of ADHF cases and was an independent predictor of 1-year mortality in community. For prediction, BUN appeared to be superior to eGFR. These findings suggest the need of close attention to kidney dysfunction among ADHF patients. |
| format | Article |
| id | doaj-art-39decc21b0a04c8dbcd5664a43b13085 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-39decc21b0a04c8dbcd5664a43b130852025-08-20T02:03:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018137310.1371/journal.pone.0181373Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance.Kunihiro MatsushitaLucia KwakNoorie HyunMarina BesselSunil K AgarwalLaura R LoehrHanyu NiPatricia P ChangJosef CoreshLisa M WruckWayne Rosamond<h4>Background</h4>Kidney dysfunction is prevalent and impacts prognosis in patients with acute decompensated heart failure (ADHF). However, most previous reports were from a single hospital, limiting their generalizability. Also, contemporary data using new equation for estimated glomerular filtration rate (eGFR) are needed.<h4>Methods and results</h4>We analyzed data from the ARIC Community Surveillance for ADHF conducted for residents aged ≥55 years in four US communities between 2005-2011. All ADHF cases (n = 5, 391) were adjudicated and weighted to represent those communities (24,932 weighted cases). The association of kidney function (creatinine-based eGFR by the CKD-EPI equation and blood urea nitrogen [BUN]) during hospitalization with 1-year mortality was assessed using logistic regression. Based on worst and last serum creatinine, there were 82.5% and 70.6% with reduced eGFR (<60 ml/min/1.73m2) and 37.4% and 26.6% with severely reduced eGFR (<30 ml/min/1.73m2), respectively. Lower eGFR (regardless of last or worst eGFR), particularly eGFR <30 ml/min/1.73m2, was significantly associated with higher 1-year mortality independently of potential confounders (odds ratio 1.60 [95% CI 1.26-2.04] for last eGFR 15-29 ml/min/1.73m2 and 2.30 [1.76-3.00] for <15 compared to eGFR ≥60). The association was largely consistent across demographic subgroups. Of interest, when both eGFR and BUN were modeled together, only BUN remained significant.<h4>Conclusions</h4>Severely reduced eGFR (<30 ml/min/1.73m2) was observed in ~30% of ADHF cases and was an independent predictor of 1-year mortality in community. For prediction, BUN appeared to be superior to eGFR. These findings suggest the need of close attention to kidney dysfunction among ADHF patients.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181373&type=printable |
| spellingShingle | Kunihiro Matsushita Lucia Kwak Noorie Hyun Marina Bessel Sunil K Agarwal Laura R Loehr Hanyu Ni Patricia P Chang Josef Coresh Lisa M Wruck Wayne Rosamond Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance. PLoS ONE |
| title | Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance. |
| title_full | Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance. |
| title_fullStr | Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance. |
| title_full_unstemmed | Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance. |
| title_short | Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance. |
| title_sort | community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure the atherosclerosis risk in communities aric study community surveillance |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181373&type=printable |
| work_keys_str_mv | AT kunihiromatsushita communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT luciakwak communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT nooriehyun communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT marinabessel communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT sunilkagarwal communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT laurarloehr communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT hanyuni communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT patriciapchang communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT josefcoresh communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT lisamwruck communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance AT waynerosamond communityburdenandprognosticimpactofreducedkidneyfunctionamongpatientshospitalizedwithacutedecompensatedheartfailuretheatherosclerosisriskincommunitiesaricstudycommunitysurveillance |