Heart failure & cardiomyopathiesMeta-analysis
Kidney function trajectories before and after hospitalization for heart failure with reduced ejection fraction
- Pooled analysis of individual patient data from two RCTs and a real-world cohort
- longitudinal
Authors' conclusion
In HFrEF, kidney function decline may precede a HF hospitalization or death by up to 1 year, linking to symptomatic congestion.
Study context
- Population
- Patients with HFrEF in EPHESUS, EMPHASIS-HF and the BARCELONA real-world cohort8,587 trial + 2048 cohort
- Comparison
- Estimated glomerular filtration rate (eGFR) trajectories in patients with vs without an heart failure (HF)-related event
- Outcome
- Longitudinal eGFR change before and after an HF-related event (HF hospitalization or HF death)
Pooled result
As reported in the abstract
eGFR slope, EPHESUS/EMPHASIS-HF
| Group | Value | Year after event |
|---|---|---|
| HF event | average −4.83 mL/min/1.73 m²/year | −3.45 mL/min/1.73 m²/year |
| No HF event | average −1.18 mL/min/1.73 m²/year |
Further pooled results
| Outcome | HF event | No HF event |
|---|---|---|
| eGFR slope, BARCELONA cohort | average −5.77 mL/min/1.73 m²/year | average −1.35 mL/min/1.73 m²/year |
| Year after event | −3.04 mL/min/1.73 m²/year | Not reported in the abstract |
- eGFR slope, BARCELONA cohort: HF event value = 1 year before the event
HF-related event incidence
- EPHESUS/EMPHASIS-HF (n=8587; median follow-up 17.1 [12.4-22.7] months)
- 14.1%
- BARCELONA (n=2048; median 47.0 [18.8-90.6] months)
- 33.8%
NYHA class
- Worsening NYHA class paralleled steeper eGFR decline before HF events
Original publication
Kidney function trajectories before and after hospitalization for heart failure with reduced ejection fraction. Eur Heart J. Published 30 July 2025. doi:10.1093/eurheartj/ehaf457
Summarised from the published abstract; every number is checked against it