Heart failure & cardiomyopathiesCohort study
Kidney Status and Events Preceding Death in Heart Failure: A Real-World Nationwide Study
- Retrospective cohort study
- nationwide registry
Authors' conclusion
In HF patients, AKI and ESKD are common in the last year of life, particularly in those with lower baseline eGFR, with kidney decline accelerating in the final months.
Study context
- Population
- Heart failure (HF) patients who died 2014–2021 with ≥1 year of HF diagnosisHF patients who died
- Participants
- 36,435 patients
- Exposure
- Estimated glomerular filtration rate (eGFR) categories 1 year before death
- Outcome
- Adverse kidney events (AKI and ESKD) preceding death
- Follow-up
- Last year of life
Main finding
As reported in the abstract
AKI and ESKD by eGFR 1 year before death
| Group | Acute kidney injury (AKI) | End-stage kidney disease (ESKD) |
|---|---|---|
| eGFR ≥60 | 6.5% (95% CI 6.1-6.9) | 0.7% (0.6-0.9) |
| eGFR 30-59 | 7.0% (6.6-7.4) | 2.6% (2.4-2.8) |
| eGFR <30 | 21.9% (20.9-22.9) | 35.5% (34.3-36.7) |
- Adverse kidney events, all patients
- 13.1%
Observational data: associations, not effects.
Further findings
Distribution of eGFR categories 1 year before death
Kidney function in the last 3 months before death
- Kidney function notably declined, with increased chronic kidney replacement therapy
Factors associated with more adverse kidney events
- Younger age, male sex, in-hospital death and greater frailty
Original publication
Kidney Status and Events Preceding Death in Heart Failure: A Real-World Nationwide Study. Eur J Heart Fail. Published 2 March 2025. doi:10.1002/ejhf.3631
Summarised from the published abstract; every number is checked against it