在心力衰竭住院期间,功能下降的预后影响
Otto Mayer1,2, Jan Bruthans1,3, Simona Bílková1,2
12nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czechia.
Kidney & blood pressure research
|December 24, 2023
概括
在心力衰竭期间严重的损伤住院显著增加了5年死亡风险. 过渡性严重功能衰竭也表明预后不佳,而轻度/中度衰竭不会影响长期生存.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床医学 临床医学
背景情况:
- 心力衰竭 (HF) 的管理包括评估并发症.
- 功能是HF预后的一个关键因素.
- 在HF住院期间过渡性功能衰竭的影响需要澄清.
研究的目的:
- 评估急性心力衰竭住院期间功能衰竭的预后意义.
- 评估与膜过率 (GFR) 中度/严重和暂时/永久下降相关的死亡风险.
主要方法:
- 分析了3639名因急性心力衰竭住院的患者队列.
- 根据基线和住院期间估计的GFR (eGFR) 来评估死亡风险.
- 为了考虑混因素,进行了统计调整.
主要成果:
- 严重的功能衰竭 (eGFR<30毫升/分钟),无论是永久的还是暂时的,与5年死亡风险增加约60%有关.
- 轻度/中度功能衰竭 (eGFR 30-59.9 mL/min) 没有显示增加死亡风险,无论其是暂时的还是永久的.
- 过渡性EGFR下降到<30毫升/分钟的死亡风险与永久性严重功能衰竭相似.
结论:
- 在心力衰竭住院期间过渡性严重功能衰竭是不良长期预后的重要指标.
- 在住院期间的中度功能衰竭似乎不会给HF患者带来额外的长期死亡风险.
- 在HF住院期间监测和管理功能对于预后评估至关重要.
相关概念视频
Factors Affecting Renal Clearance: Renal Impairment
95
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
95
Heart Failure Drugs: Diuretics
394
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
394
Renal Failure: Dose Adjustments
94
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
94
Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
436
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
436
Dialysis
320
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
320


