Prognosis After &gt;50% Decline in eGFR in Heart Failure Patients

doi:10.1016/j.jchf.2025.02.027

Heart failure & cardiomyopathiesCohort study

Prognosis After >50% Decline in Estimated Glomerular Filtration Rate (eGFR) in Heart Failure Patients

JACC Heart FailPublished 30 Jun 2025

Nationwide cohort study
landmark analysis

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Authors' conclusion

In this large real-world study, a >50% eGFR decline was associated with increased mortality and ESKD risk irrespective of diabetes status, underscoring its clinical relevance.

Study context

Population: New-onset heart failure (HF) patients diagnosed 2014–2021 who survived the first year post-diagnosis
Participants: 45,385 patients

Exposure: eGFR 25%-50% decline and >50% decline vs stable eGFR
Outcome: All-cause mortality and end-stage kidney disease (ESKD)

Main finding

As reported in the abstract

5-year mortality, no DM

Stable eGFR33.2%

25%-50% decline53.8%

>50% decline63.0%

5-year mortality, DM

Stable eGFR42.8%

25%-50% decline58.6%

>50% decline65.6%

ESKD, no DM

Stable eGFR3.3%

25%-50% decline7.9%

>50% decline11.5%

ESKD, DM

Stable eGFR7.4%

25%-50% decline15.6%

>50% decline21.1%

Observational data: associations, not effects.

Further findings

eGFR trajectory at 1 year

Stable eGFR82.5%

25%-50% decline14.2%

>50% decline3.3%

Original publication

Prognosis After >50% Decline in eGFR in Heart Failure Patients. JACC Heart Fail. Published 30 June 2025. doi:10.1016/j.jchf.2025.02.027

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Summarised from the published abstract; every number is checked against it