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Updated: Mar 25, 2026
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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
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Acute declines in kidney function with thiazide plus loop diuretics vs loop diuretics alone in acute decompensated
Wendy McCallum1, Hocine Tighiouart1,2,3, Marcelle Tuttle1,3
1Division of Nephrology, Tufts Medical Center, Boston, MA.
Summary
Acute declines in estimated glomerular filtration rate (eGFR) in patients with acute decompensated heart failure (ADHF) were not linked to increased mortality or hospitalizations. Early eGFR changes did not predict adverse cardiovascular outcomes in this study population.
Area of Science:
- Nephrology
- Cardiology
- Clinical Trials
Background:
- The relationship between acute kidney injury, indicated by estimated glomerular filtration rate (eGFR) decline, and cardiovascular outcomes in acute decompensated heart failure (ADHF) is not well-established.
- Previous studies have yielded inconsistent findings regarding the prognostic value of eGFR changes in ADHF patients.
Purpose of the Study:
- To investigate the association between early acute declines in eGFR and subsequent cardiovascular outcomes, specifically mortality and a composite of mortality or heart failure hospitalization.
- To determine if the timing of eGFR decline influences its association with adverse cardiovascular events in ADHF.
Main Methods:
- Analysis of data from the CLOROTIC Trial, which randomized ADHF patients to thiazide or placebo.
- Evaluation of percentage change in eGFR at 2 and 4 days post-randomization.
- Utilized multivariable Cox models to assess the relationship between eGFR changes and clinical outcomes.
Main Results:
- Median eGFR decline was observed in both thiazide and placebo groups at 2 and 4 days.
- No statistically significant association was found between eGFR decline at 2 or 4 days and the risk of mortality.
- Similarly, no significant association was detected between eGFR decline and the composite outcome of mortality or HF hospitalization.
Conclusions:
- Early acute declines in eGFR following admission for ADHF were not associated with an increased risk of mortality or HF hospitalizations.
- The timing of eGFR decline (2 vs. 4 days) did not alter its lack of association with adverse cardiovascular outcomes in this cohort.
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