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Updated: Jul 11, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Prognostic value of reduced kidney function and anemia in patients with chronic heart failure
Mario Petretta1, Franco Scopacasa, Luca Fontanella
1Department of Internal Medicine, Cardiology, Heart Surgery and Immunological Sciences, University of Naples Federico II, Via S Pansini no. 5, Naples, Italy.
Insights
Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) and reduced kidney function are significant predictors of mortality in chronic heart failure (CHF) patients, while anemia is not.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Chronic heart failure (CHF) is a complex condition with significant mortality.
- Prognostic markers are crucial for risk stratification in CHF patients.
- The combined impact of NT-proBNP, renal dysfunction, and anemia on CHF prognosis requires further elucidation.
Purpose of the Study:
- To assess the prognostic value of NT-proBNP, renal dysfunction, and anemia in patients with CHF.
- To identify independent predictors of mortality in this population.
Main Methods:
- A prospective cohort study of 153 CHF patients was conducted.
- Clinical, echocardiographic, and laboratory data were collected.
- Renal dysfunction was defined as GFR < 60 ml/min; anemia as hematocrit < 35%.
Main Results:
- Renal dysfunction was present in 37% and anemia in 25% of patients.
- During follow-up (median 456 days), 32 deaths occurred.
- Multivariate analysis identified elevated NT-proBNP and reduced GFR as significant predictors of mortality.
Conclusions:
- Increased NT-proBNP levels and decreased kidney function are independent risk factors for mortality in CHF.
- Anemia was not found to be an independent predictor of mortality in this cohort.
- These findings highlight the importance of monitoring NT-proBNP and renal function for risk assessment in CHF.
Objectives:
The present study aimed to evaluate the prognostic value of B-type natriuretic peptide (N-proBNP), renal dysfunction and anemia in chronic heart failure (CHF) patients.
Methods:
We analyzed data from a prospective cohort of 153 patients (mean age 64 years) with CHF referred to our hospital center. Clinical, echocardiographic and laboratory data were drawn during hospital recovery in all patients. Kidney dysfunction was defined as a glomerular filtration rate (GFR) < 60 ml/min and anemia as a hematocrit < 35%. After discharge, patients attended the outpatient clinic of our institution.
Results:
Kidney dysfunction was diagnosed in 37% of cases, whereas anemia was present in 25% of patients. During follow-up (median time 456 days), 32 patients died. Multivariate Cox proportional hazard model revealed that N-proBNP [hazard ratio (HR) = 1.002; P < 0.001] and GFR (HR = 0.972; P < 0.005) were significant predictors for mortality after adjustment for confounding variables. Kaplan-Maier analysis demonstrated a progressive decrease in survival from lowest to highest tertiles of N-proBNP values (log rank = 28.7; P < 0.001) and from higher to lower GFR values (log rank = 5.63; P < 0.01). Moreover, parametric survival analysis by the Weibull model demonstrated that the estimated probability of survival adjusted for N-proBNP values was higher in patients with GFR > or = 60 ml/min than in those with GFR < 60 ml/min (P < 0.001).
Conclusion:
Increased N-proBNP and decreased kidney function, but not anemia, are independent risk factors for mortality in patients with CHF.
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