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Acute kidney injury patterns in acute heart failure

2023-05Artigo científico Acesso aberto
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dc.contributor.authorPresume, João
dc.contributor.authorCunha, Gonçalo J L
dc.contributor.authorRocha, Bruno M L
dc.contributor.authorLandeiro, Luís
dc.contributor.authorTrevas, Sara
dc.contributor.authorRoldão, Marta
dc.contributor.authorInês Silva, M
dc.contributor.authorMadeira, Margarida
dc.contributor.authorMaltês, Sérgio
dc.contributor.authorRodrigues, Catarina
dc.contributor.authorAraújo, Inês
dc.contributor.authorFonseca, Cândida
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.pblSociedade Portuguesa de Cardiologia | Elsevier
dc.date.accessioned2023-03-13T22:25:42Z
dc.date.available2023-03-13T22:25:42Z
dc.date.issued2023-05
dc.descriptionCopyright © 2023 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.
dc.description.abstractINTRODUCTION: Acute decompensated heart failure (ADHF) admissions are frequently complicated by different patterns of serum creatinine (SCr) elevation. We aimed to assess the prognostic impact of worsening renal function (WRF) based on the timing of its occurrence. METHODS: This was a retrospective cohort of patients admitted for ADHF. Standard WRF was defined as an increase in SCr of ≥0.3 mg/dl during hospitalization. WRF timing was classified as early (within 48 hours of admission) or late (>48 hours). Acute kidney injury (AKI) at admission was defined as a rise in SCr of ≥0.3 mg/dl from outpatient baseline measurement to first measurement at admission. The primary endpoint was a composite of all-cause mortality or hospitalization for cardiovascular events at one-year follow-up. RESULTS: Overall, 249 patients were included (mean age 77±11 years, 62% with preserved left ventricular ejection fraction). Early WRF occurred in 49 patients (19.7%) and was associated with a higher risk of the primary outcome (HR 2.49; 95% CI 1.66-3.73), whereas late WRF was not (p=0.411). After stratification for the presence of early WRF and/or AKI at admission, only patients with early WRF but no AKI at admission and patients with both AKI at admission and early WRF showed a higher risk of the primary outcome after multivariate Cox regression. CONCLUSION: Early WRF was associated with a higher risk of the primary outcome. The timing of WRF seems to be an important factor to take into account when considering the prognostic impact of creatinine variations during hospitalization for ADHF.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent762606
dc.identifier.doi10.1016/j.repc.2022.06.015
dc.identifier.issn0304-4750
dc.identifier.otherPURE: 54519703
dc.identifier.otherPURE UUID: 7c005171-e0d6-4b8a-abca-1ece988869b6
dc.identifier.otherPubMed: 36828180
dc.identifier.otherScopus: 85163373828
dc.identifier.urihttp://hdl.handle.net/10362/150474
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAcute heart failure
dc.subjectAcute kidney injury
dc.subjectCardiorenal syndrome
dc.subjectWorsening renal function
dc.titleAcute kidney injury patterns in acute heart failureen
dc.title.subtitleThe prognostic value of worsening renal function and its timingen
dc.typejournal article
degois.publication.firstPage423
degois.publication.issue5
degois.publication.lastPage430
degois.publication.titleRevista Portuguesa de Cardiologia
degois.publication.volume42
dspace.entity.typePublication
rcaap.rightsopenAccess

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