Heart failure & cardiomyopathies
Improvement in Renal Function During the Treatment of Acute Decompensated Heart Failure: Relationship With Markers of Renal Tubular Injury and Prognostic Importance
Authors' conclusion
IRF during decongestive therapy for acute decompensated heart failure was not associated with improved markers of renal tubular injury and was associated with worsened survival, likely driven by the presence of greater underlying cardiorenal dysfunction and more severe congestion.
Study context
- Population
- Patients with acute decompensated HF (ROSE-AHF)
- Participants
- 277 patients
- Comparison
- In renal function (IRF) vs WRF vs stable renal function (SRF)
- IRFn = 75
- Worsening renal functionn = 53
- SRFn = 149reference
Primary result
As reported in the abstract
Relative change in renal tubular injury markers (NGAL, NAG, KIM-1) · baseline to 72 hours
- No differences in relative change in NGAL, NAG or KIM-1 between renal function groups
- Ptrend>0.19 for all
Further findings
| Outcome | IRF | Worsening renal function | SRF | HR (CI) | P value | |
|---|---|---|---|---|---|---|
| SurvivalIRFvs SRFWorse survival with IRF | 27% | — not stated in the abstract | 54% | 1.98 (1.10–3.58) | P = 0.024 | |
| 0.20.5125Hazard ratio (log scale) |
— not stated in the abstract
Admission eGFR
Cumulative urine output
| Outcome | IRF | Worsening renal function | SRF |
|---|---|---|---|
| Weight loss | −9.0 (range −12.4–-5.3) lb | −5.1 (range −8.1–-1.3) lb | −7.1 (range −11.9–-3.2) lb |
- Admission eGFR: Ptrend=0.032
- Cumulative urine output: Ptrend=0.024
- Weight loss: Ptrend<0.001
Diuretic doses
- Similar diuretic doses
- P for trend = 0.16
Original publication
Improvement in Renal Function During the Treatment of Acute Decompensated Heart Failure: Relationship With Markers of Renal Tubular Injury and Prognostic Importance. Circ Heart Fail. Published 26 January 2023. doi:10.
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