Abstract 17313: Impact of Late Onset Worsening Renal Function on Outcomes in Patients With Acute Decompensated Heart Failure
Background: Development of worsening renal function (WRF) in acute decompensated heart failure (ADHF) patients was associated with poor clinical outcome in several past studies. In most of these studies, WRF was defined as the occurrence during several days from admission, however we often experience WRF in chronic phase during admission. The purpose of this study was to focus on onset time of WRF and its clinical importance.
Methods: We evaluated 250 patients admitted our hospital with ADHF between April 2014 to May 2015. We excluded the patients who were on dialysis and died during the admission. WRF was defined as the occurrence, at any time during the hospitalization, of both a ≥25% and a ≥0.3 mg/dL increase in serum creatinine from admission. We divided patients developing WRF into two groups, early WRF (≤ 5 days from admission) and late WRF (≥ 6 days from admission). Outcomes (ADHF readmission and all cause death) were recorded during follow-up (mean 50.3 ± 28.5 weeks).
Results: A total of 224 patients were included in this study. Among these patients, WRF occurred in 114 (50.9 %) patients, 57 (25.5 %) with early onset of WRF, 57 (25.5 %) with late onset of WRF. Patients with late onset of WRF had a higher rate of readmission with ADHF and all cause death than that in patients without WRF (47.4 % vs. 31.2 %, p=0.041), however not in patients with early onset of WRF (36.8 % vs 31.2 %, p=0.46). Late onset of WRF was an independent predictor of readmission or mortality (hazard ratio: 2.61, 95 % confidence interval: 1.47-4.62, p =0.0012). The most important predictor of developing late onset of WRF was reduction in body weight during admission (7.68 ± 0.63 kg vs. 4.89 ± 0.37 kg, p=0.022).
Conclusion: Not early but late onset of WRF was independently related to poor prognosis in patients with ADHF. Patients with late onset of WRF showed greater reduction in body weight but worse prognosis, so the goal of decongestion or the way of decongestion might be important.
Author Disclosures: K. Ishibashi: None. T. Yamane: None. R. Murai: None. Y. Sasaki: None. M. Ota: None. K. Kimu: None. T. Kitai: None. N. Ehara: None. A. Kobori: None. M. Kinoshita: None. S. Kaji: None. Y. Furukawa: None.
- © 2016 by American Heart Association, Inc.