Estimated creatinine clearance: a determinant prognostic factor in heart failure

Area of Science:

• Cardiology
• Nephrology
• Clinical Prognostics

Background:

• Heart failure patients with kidney failure (KF) face poor prognoses.
• Even subtle kidney dysfunction may hold prognostic significance.

Purpose of the Study:

• To evaluate the correlation between creatinine clearance and 2-year survival in heart failure outpatients.
• To determine the prognostic value of estimated kidney function in heart failure.

Main Methods:

• 423 heart failure outpatients were analyzed, categorized by chronic kidney disease stages based on Cockcroft formula creatinine clearance.
• Kidney failure (KF) was defined as creatinine clearance < 60 ml/min.

Main Results:

• 52% of patients had kidney failure (KF).
• Two-year mortality increased progressively with declining creatinine clearance, from 3.2% (≥90 ml/min) to 80% (<15 ml/min or dialysis).
• Mortality was significantly higher in patients with KF (30.4%) compared to those without (10.3%).

Conclusions:

• Creatinine clearance, estimated via the Cockcroft formula, strongly predicts prognosis in heart failure patients.
• Mild kidney function impairment is associated with increased mortality in heart failure populations.