کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6151821 1596561 2013 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Clinical characteristics and prognostic influence of renal dysfunction in heart failure patients with preserved ejection fraction
ترجمه فارسی عنوان
ویژگی های بالینی و تأثیر پیش آگهی اختلال عملکرد کلیه در بیماران مبتلا به نارسایی قلبی با کسر تخلیه محافظت شده
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
چکیده انگلیسی


- Determine the impact of renal dysfunction on all-cause mortality in HFPEF patients.
- Evaluate characteristics of patients that deteriorate renal function in follow-up.
- A significant degree of renal dysfunction is common among HFPEF patients.
- Impaired renal function is correlated with higher mortality rate.
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- Decline in renal function is associated with diabetes and MRA prescriptions.

BackgroundRenal dysfunction is common in patients with heart failure (HF) and is associated with high mortality. This relationship is well established in HF and reduced ejection fraction (HFREF), however, it is not fully understood in HF and preserved ejection fraction (HFPEF). The aim of this study was to determine the impact of renal dysfunction on all-cause mortality in HFPEF patients and to evaluate the clinical characteristics of patients that deteriorate renal function in the first year of follow-up.MethodsWe evaluated the patients with HFPEF included in the RICA registry. This is a multi-center and prospective cohort study that includes patients admitted for decompensated HF. Estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN) and plasma creatinine concentrations were used for renal function assessment at admission and after one year of follow up.ResultsA total of 455 patients (mean age 78 ± 8.1 years; 62% women) were included, of whom 265 (58.2%) had eGFR < 60 mL/min/1.73 m2. After adjustment for covariates, only lower admission eGFR remained significantly predictive of all-cause mortality (HR 2.97; 95% CI 1.59-5.53). After one year of follow-up 16.6% of patients deteriorated at least 25% of eGFR. These patients were more likely to be diabetic (54.5% vs 42.6%; p = 0.039) and had a higher rate of prescription of mineralcorticoid receptor antagonist (MRA) agents (47% vs 23.3%; p < 0.001).ConclusionRenal dysfunction is frequently associated with HFPEF. eGFR below normal is strongly associated with mortality. Further decline of renal function is frequent especially among diabetic and patients treated with MRA agents.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: European Journal of Internal Medicine - Volume 24, Issue 7, October 2013, Pages 677-683
نویسندگان
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