Risk Stratification of Acute Kidney Injury Using the Blood Urea Nitrogen/Creatinine Ratio in Patients With Acute Decompensated Heart Failure
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- Takaya Yoichi
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Yoshihara Fumiki
- Department of Hypertension and Nephrology, National Cerebral and Cardiovascular Center
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- Yokoyama Hiroyuki
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Kanzaki Hideaki
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Kitakaze Masafumi
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Goto Yoichi
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Anzai Toshihisa
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Yasuda Satoshi
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Ogawa Hisao
- Department of Cardiology, National Cerebral and Cardiovascular Center
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- Kawano Yuhei
- Department of Hypertension and Nephrology, National Cerebral and Cardiovascular Center
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Background:Risk stratification of acute kidney injury (AKI) is important for acute decompensated heart failure (ADHF). The aim of this study was to determine whether clinical markers, such as the blood urea nitrogen/creatinine ratio (BUN/Cr) or BUN or creatinine values alone, stratify the risk of AKI for mortality.Methods and Results:In all, 371 consecutive ADHF patients were enrolled in the study. AKI was defined as serum creatinine ≥0.3 mg/dl or a 1.5-fold increase in serum creatinine levels within 48 h. During ADHF therapy, AKI occurred in 99 patients; 55 patients died during the 12-month follow-up period. Grouping patients according to AKI and a median BUN/Cr at admission of 22.1 (non-AKI+low BUN/Cr, non-AKI+high BUN/Cr, AKI+low BUN/Cr, and AKI+high BUN/Cr groups) revealed higher mortality in the AKI+high BUN/Cr group (log-rank test, P<0.001). Cox’s proportional hazard analysis revealed an association between AKI+high BUN/Cr and mortality, whereas the association with AKI+low BUN/Cr did not reach statistical significance. When patients were grouped according to AKI and median BUN or creatinine values at admission, AKI was associated with mortality, regardless of BUN or creatinine.Conclusions:The combination of AKI and elevated BUN/Cr, but not BUN or creatinine individually, is linked with an increased risk of mortality in ADHF patients, suggesting that the BUN/Cr is useful for risk stratification of AKI. (Circ J 2015; 79: 1520–1525)
収録刊行物
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- Circulation Journal
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Circulation Journal 79 (7), 1520-1525, 2015
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390001205106928128
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- NII論文ID
- 130005083935
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 026523587
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- PubMed
- 25854814
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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