Renal Dysfunction in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction

• DOI: 10.1161/circheartfailure.111.966242
• Publication Date: 2012-03-23T15:00:31Z
• Authors: Finlay A. McAlister; Justin Ezekowitz; Luigi Tarantini; Iain Squire; Michel Komajda; Antoni Bayes-Genis; Israel Gotsman; Gillian Whalley; Nikki Earle; Katrina K. Poppe; Robert N. Doughty
• Keywords: Adult; Male; Enfermedad cardiovascular; heart failure; Kidney; Models, Biological; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Prevalence; Humans; kidney disease chronic; Prospective Studies; Aged; Aged, 80 and over; Heart Failure; Age Factors; Stroke Volume; Middle Aged; Prognosis; 3. Good health; Survival Rate; Chronic Disease; Female; Kidney Diseases; prognosis; Glomerular Filtration Rate

Background— Prior studies in heart failure (HF) have used the Modification of Diet Renal Disease (MDRD) equation to calculate estimated glomerular filtration rate (eGFR). The Chronic Kidney Disease-Epidemiology Collaboration Group (CKD-EPI) provides a more-accurate eGFR than MDRD when compared against radionuclide gold standard. prevalence and prognostic import renal dysfunction HF if CKD-EPI is rather uncertain. Methods Results— We individual patient data from 25 prospective stratify patients with by using equations examined survival across strata. In 20 754 (15 962 reduced ejection fraction [HF-REF] 4792 preserved [HF-PEF]; mean age, 68 years; deaths per 1000 patient-years, 151; 95% CI, 146–155), 10 589 (51%) 11 422 (55%) had an <60 mL/min equations, respectively. Use resulted 3760 (18%) being reclassified into different risk strata; 3089 (82%) were placed lower category exhibited higher all-cause mortality rates (net reclassification improvement CKD-EPI, 3.7%; 1.5%–5.9%). Reduced was stronger predictor HF-REF HF-PEF. Conclusions— leads estimates categorization risk. function more closely related outcomes