Prognostic Comparison of the Estimations of Renal Function in Patients With Acute Heart Failure

• Cheng Yu-Lun

  Department of Medicine, Taipei Veterans General Hospital Department of Medicine, National Yang-Ming University Institute of Public Health, National Yang-Ming University

• Sung Shih-Hsien

  Department of Medicine, Taipei Veterans General Hospital Department of Medicine, National Yang-Ming University Institute of Public Health, National Yang-Ming University

• Cheng Hao-Min

  Department of Medical Education, Taipei Veterans General Hospital Cardiovascular Research Center, National Yang-Ming University Department of Medicine, National Yang-Ming University

• Huang Jui-Tzu

  Department of Medicine, National Yang-Ming University

• Guo Chao-Yu

  Institute of Public Health, National Yang-Ming University

• Hsu Pai-Feng

  Healthcare and Management Center, Taipei Veterans General Hospital Department of Medicine, National Yang-Ming University Institute of Public Health, National Yang-Ming University

• Yu Wen-Chung

  Department of Medicine, Taipei Veterans General Hospital Cardiovascular Research Center, National Yang-Ming University Department of Medicine, National Yang-Ming University

• Chen Chen-Huan

  Department of Medical Education, Taipei Veterans General Hospital Cardiovascular Research Center, National Yang-Ming University Department of Medicine, National Yang-Ming University Institute of Public Health, National Yang-Ming University

抄録

Background: The prognostic significance of the eGFR calculated by either the four-level Race Chronic Kidney Disease-Epidemiology Collaboration study equation (CKD-EPI4R) or the Chinese-modified Modification of Diet in Renal Disease equation (cMDRD) has not been compared in Asian populations with acute heart failure (AHF). Methods and Results:A total of 3,044 patients hospitalized for AHF were enrolled. The National Death Registry was linked to identify deaths within a 5-year follow-up. Net reclassification improvement (NRI) was calculated to compare the prognostic value of either eGFR equation. During a median follow-up of 23.3 months, 1,424 (47%) patients died. Both eGFR_cMDRDand eGFR_CKD-EPI4Rwere independently predictive of death in the total study population (hazard ratio and 95% confidence intervals per 1-SD: 0.76, 0.71–0.81 and 0.74, 0.70–0.79, respectively), and in the subgroups of either reduced (HFrEF) or preserved (HFpEF) ejection fraction, after accounting for important confounders. With reference to eGFR_cMDRD, eGFR_CKD-EPI4Rmay improve the NRI by 2.0% (0.8–3.2%) for the prediction of death. The prognostic value of the CKD stages categorized by eGFR_CKD-EPI4Rsignificantly outperformed eGFR_cMDRDwith a categorical NRI of 9.5% (4.7–14.3%) in the total study population, 11.5% in HFrEF, and 8.3% in HFpEF. Conclusions:Both eGFR_cMDRDand eGFR_CKD-EPI4Rwere independently associated with long-term survival in patients with AHF. However, the CKD stages derived from eGFR_CKD-EPI4Rimproved the risk stratification of death, compared with eGFR_cMDRD.

収録刊行物

• Circulation Journal

  Circulation Journal 83 (4), 767-774, 2019-03-25

  一般社団法人 日本循環器学会

キーワード

• Chronic kidney disease
• Glomerular filtration rate
• Heart failure
• Mortality

詳細情報

• CRID: 1390845713069071104
• NII論文ID: 40021855896
• NII論文ID: 130007620471
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-18-1013
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 029609681
• PubMed: 30787217
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I029609681
• Web Site: https://www.jstage.jst.go.jp/article/circj/83/4/83_CJ-18-1013/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2019305057
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
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