Related Experiment Videos
Aggravated renal dysfunction during intensive therapy for advanced chronic heart failure
M S Weinfeld1, G M Chertow, L W Stevenson
1Cardiovascular Division, Department of Medicine, Brigham Women's Hospital, Boston, MA 02115, USA.
American Heart Journal
|July 30, 1999
Summary
Aggravated renal dysfunction (ARD) is common in advanced heart failure patients receiving intensive therapy. This condition is linked to older age, lower creatinine clearance, atrial fibrillation, longer hospital stays, and increased mortality.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Chronic heart failure (CHF) often coexists with impaired renal function.
- Renal function may deteriorate during CHF treatment.
- The incidence, predictors, and consequences of aggravated renal dysfunction (ARD) in advanced CHF patients are not well understood.
Purpose of the Study:
- To investigate the incidence, predictors, and consequences of ARD in patients with advanced chronic heart failure undergoing intensive therapy.
- To identify factors associated with the development of ARD.
- To assess the clinical significance and outcomes of ARD in this patient population.
Main Methods:
- Retrospective review of 48 consecutive patients hospitalized for advanced CHF treatment.
- Intravenous diuretic therapy administered, aiming for >/=2 kg weight loss.
- Evaluation included baseline renal function, echocardiography, and hemodynamic measurements in a subset of patients.
Main Results:
- ARD (defined as >/=25% increase in serum creatinine to >/=2 mg/dL) developed in 10 (21%) patients.
- Patients with ARD were older, had lower baseline creatinine clearance, and were more likely to have atrial fibrillation.
- ARD was associated with longer hospital stays and increased post-discharge mortality (relative risk 5.3).
Conclusions:
- Aggravated renal dysfunction is a common and clinically significant complication in patients undergoing intensive therapy for advanced heart failure.
- Complex cardiorenal interactions likely underlie the relationship between baseline factors, ARD, and adverse outcomes.
- Further research into the causes and prevention of ARD during heart failure therapy is warranted to improve patient outcomes.