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Blood urea nitrogen to creatinine ratio and long-term survival in patients with chronic heart failure
Yajiao Wang1, Xia Xu1, Shuqing Shi1
1Guang 'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, China.
Insights
The Blood urea nitrogen to creatinine ratio (BUN/Scr ratio) is linked to worse outcomes in patients with chronic heart failure (CHF) and kidney injury. A higher BUN/Scr ratio independently predicts a greater risk of all-cause death in these patients.
Area of Science:
- Cardiology
- Nephrology
- Clinical Prognostics
Background:
- Chronic heart failure (CHF) is a complex condition often complicated by renal injury.
- Assessing prognostic markers in CHF patients with renal impairment is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the association between the Blood urea nitrogen to creatinine ratio (BUN/Scr ratio) and the prognosis of patients with chronic heart failure (CHF) complicated by renal injury.
Main Methods:
- A retrospective analysis of 504 CHF patients with renal injury was conducted.
- The optimal cutoff value for the BUN/Scr ratio was determined using ROC analysis (19.37).
- Patients were categorized into two groups (BUN/Scr < 19.37 and BUN/Scr ≥ 19.37) for survival analysis using Kaplan-Meier curves and Cox regression.
Main Results:
- Patients with a BUN/Scr ratio ≥ 19.37 exhibited a significantly higher mortality rate compared to those with a ratio < 19.37.
- Multivariate analysis revealed that a BUN/Scr ratio ≥ 19.37 was an independent predictor of all-cause death (HR = 1.885, P = 0.001).
- Subgroup analyses indicated that NYHA class and estimated glomerular filtration rate (eGRF) influenced the relationship between BUN/Scr ratio and CHF prognosis.
Conclusions:
- The BUN/Scr ratio is significantly associated with poor prognosis in patients with CHF and renal injury.
- The BUN/Scr ratio serves as an independent predictor of all-cause mortality in this patient population.
- Clinical factors like NYHA class and eGRF may modify the prognostic value of the BUN/Scr ratio.
Objectives:
To explore the correlation between Blood urea nitrogen to creatinine ratio (BUN/Scr ratio) and prognosis of patients with chronic heart failure complicated with renal injury.
Methods:
A retrospective analysis of 504 patients hospitalized in Guang 'anmen Hospital, Chinese Academy of Traditional Chinese Medicine from March 2006 to June 2014 was conducted. The baseline data were analyzed, and the cutoff value was obtained by receiver operator characteristic curve (ROC) analysis, according to the cutoff value, all the participants were divided into two groups, BUN/Scr < 19.37 group (280 cases) and BUN/Scr ≥ 19.37 group (224 cases). The main end point was defined as all-cause death. The long-term mortality of the two groups was evaluated, and Kaplan-Meier survival curve was drawn. Univariate analysis was performed on all the variables affecting the patient's prognosis, and the variables with P < 0.05 were put into Cox regression model, and subgroup analysis was performed on the variables that might affect the patient's prognosis.
Results:
The baseline data of 504 patients were analyzed and found that the median follow up was 683. Through ROC analysis of 504 subjects, the cutoff value of BUN/Scr was 19.37. The results of Kaplan-Meier survival curve showed that the mortality rate of patients with ratio ≥ 19.37 was higher than that of patients with ratio < 19.37. After multivariate analysis, COX regression model showed that the mortality of patients with BUN/Scr ≥ 19.37 was 1.885 times that of patients with BUN/Scr < 19.37 [HR = 1.885 (1.298-2.737), P = 0.001]. Subgroup analysis showed that the relationship between BUN/Scr and the prognosis of CHF was influenced by NYHA and eGRF (P < 0.05).
Conclusions:
BUN/Scr ratio is related to the poor prognosis of patients with CHF, and is an independent predictor of all-cause death.
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