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Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

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Related Experiment Video

Updated: May 14, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Renal function in heart failure: a disparity between estimating function and predicting mortality risk.

Max Plischke1, Stephanie Neuhold, Maria Kohl

  • 1Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

European Journal of Heart Failure
|February 23, 2013
PubMed
Summary
This summary is machine-generated.

The Chronic Kidney Disease Epidemiology Collaboration (eGFR CKD-EPI) equation marginally outperformed the Modification of Diet in Renal Disease (eGFR MDRD-4) equation for predicting mortality in heart failure patients. Renal function estimates vary significantly between equations, impacting treatment decisions.

Keywords:
Heart failureMortalityRenal function

Related Experiment Videos

Last Updated: May 14, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Epidemiology

Background:

  • Renal function is a critical prognostic indicator in heart failure (HF).
  • Existing methods for estimating renal function, such as the Cockcroft-Gault (eCcr) and Modification of Diet in Renal Disease (eGFR MDRD-4) equations, may inaccurately assess true renal function in certain patient populations.
  • Accurate assessment of renal function is vital for guiding HF management and therapeutic choices.

Purpose of the Study:

  • To evaluate and compare the prognostic accuracy of three distinct equations for estimating renal function in predicting all-cause mortality among patients with systolic heart failure.
  • Specifically, to compare the predictive performance of the Chronic Kidney Disease Epidemiology Collaboration (eGFR CKD-EPI) equation against the four-variable Modification of Diet in Renal Disease (eGFR MDRD-4) equation and the Cockcroft-Gault (eCcr) equation.

Main Methods:

  • A cohort of 800 outpatients with systolic heart failure was followed for a median of 121 months.
  • The study compared estimated renal function values derived from eGFR CKD-EPI, eGFR MDRD-4, and eCcr.
  • Statistical analyses included assessing systematic differences, agreement (generalized kappa), reclassification of patients into different estimated glomerular filtration rate (eGFR) categories, and predictive performance metrics (AUC, PEV, NRI, IDI) for all-cause mortality over 5 years.

Main Results:

  • Significant discrepancies were observed between the different renal function estimation equations, with up to 35.4% of patients being reclassified into different eGFR categories when comparing eGFR CKD-EPI with eCcr and eGFR MDRD-4.
  • The eGFR CKD-EPI equation demonstrated marginally superior performance in predicting all-cause mortality compared to the eGFR MDRD-4 equation.
  • Key predictive metrics, including AUC, PEV, NRI, and IDI, were significantly higher for eGFR CKD-EPI than for eGFR MDRD-4 over a 5-year follow-up period.

Conclusions:

  • The eGFR CKD-EPI equation offers a marginally improved prediction of all-cause mortality in heart failure patients compared to the eGFR MDRD-4 equation.
  • The substantial differences in estimated renal function across the evaluated equations highlight their potential impact on clinical decision-making and therapy selection in heart failure management.