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dc.contributor.authorIsmailov, Rovshan M.
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorLessard, Darleen M.
dc.contributor.authorSpencer, Frederick A.
dc.date2022-08-11T08:10:39.000
dc.date.accessioned2022-08-23T17:15:34Z
dc.date.available2022-08-23T17:15:34Z
dc.date.issued2007-10-25
dc.date.submitted2010-05-27
dc.identifier.citationNephron Clin Pract. 2007;107(4):c147-55. Epub 2007 Oct 22. <a href="http://dx.doi.org/10.1159/000110035">Link to article on publisher's site</a>
dc.identifier.issn1660-2110 (Linking)
dc.identifier.doi10.1159/000110035
dc.identifier.pmid17957126
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47195
dc.description.abstractBACKGROUND: Patients with heart failure (HF) and kidney disease have a poor long-term outlook which has provided impetus for the identification of factors of prognostic importance and more fully understanding the impact of kidney dysfunction in patients with HF. OBJECTIVES: Our objectives were to describe the characteristics, hospital treatment practices, as well as hospital and long-term outcomes in patients with varying degrees of kidney dysfunction who were hospitalized with acute HF at all medical centers in a large New England metropolitan area. METHODS: Residents of the Worcester metropolitan area hospitalized with clinical findings of decompensated HF at 11 greater Worcester medical centers during 1995 and 2000 comprised the study sample. Kidney function was classified into 4 categories of estimated glomerular filtration rate (eGFR) for purposes of analysis: <30 (n = 569), 30-44 (n = 725), 45-59 (n = 763), and > or =60 (n = 2,293) ml/min per 1.73 m(2). RESULTS: The average age of the study sample was 76 years and 57% were women. Patients with severe kidney dysfunction were less likely to receive angiotensin-converting enzyme inhibitors, diuretics and digoxin during hospitalization for acute HF compared to patients with more normal kidney function. Patients with lower eGFR levels had higher in-hospital and post-discharge death rates in comparison to those with higher levels of eGFR. CONCLUSION: Our results demonstrate the impact of renal impairment on the prognosis of patients with decompensated HF. Our findings highlight the less than optimal management of these high-risk patients. Increased surveillance and enhanced treatment of patients with HF and kidney dysfunction remains warranted to improve the survival outlook of these patients.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=17957126&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1159/000110035
dc.subjectAdult
dc.subjectAge Distribution
dc.subjectAged
dc.subjectAnalysis of Variance
dc.subjectCohort Studies
dc.subjectComorbidity
dc.subjectCross-Sectional Studies
dc.subjectFemale
dc.subjectHeart Failure
dc.subjectHumans
dc.subjectIncidence
dc.subjectKidney Failure
dc.subjectKidney Function Tests
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProbability
dc.subjectPrognosis
dc.subjectProportional Hazards Models
dc.subjectRenal Dialysis
dc.subjectRetrospective Studies
dc.subjectRisk Assessment
dc.subjectSeverity of Illness Index
dc.subjectSex Distribution
dc.subjectSurvival Analysis
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleDecompensated heart failure in the setting of kidney dysfunction: a community-wide perspective
dc.typeJournal Article
dc.source.journaltitleNephron. Clinical practice
dc.source.volume107
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/340
dc.identifier.contextkey1333093
html.description.abstract<p>BACKGROUND: Patients with heart failure (HF) and kidney disease have a poor long-term outlook which has provided impetus for the identification of factors of prognostic importance and more fully understanding the impact of kidney dysfunction in patients with HF.</p> <p>OBJECTIVES: Our objectives were to describe the characteristics, hospital treatment practices, as well as hospital and long-term outcomes in patients with varying degrees of kidney dysfunction who were hospitalized with acute HF at all medical centers in a large New England metropolitan area.</p> <p>METHODS: Residents of the Worcester metropolitan area hospitalized with clinical findings of decompensated HF at 11 greater Worcester medical centers during 1995 and 2000 comprised the study sample. Kidney function was classified into 4 categories of estimated glomerular filtration rate (eGFR) for purposes of analysis: <30 (n = 569), 30-44 (n = 725), 45-59 (n = 763), and > or =60 (n = 2,293) ml/min per 1.73 m(2). RESULTS: The average age of the study sample was 76 years and 57% were women. Patients with severe kidney dysfunction were less likely to receive angiotensin-converting enzyme inhibitors, diuretics and digoxin during hospitalization for acute HF compared to patients with more normal kidney function. Patients with lower eGFR levels had higher in-hospital and post-discharge death rates in comparison to those with higher levels of eGFR.</p> <p>CONCLUSION: Our results demonstrate the impact of renal impairment on the prognosis of patients with decompensated HF. Our findings highlight the less than optimal management of these high-risk patients. Increased surveillance and enhanced treatment of patients with HF and kidney dysfunction remains warranted to improve the survival outlook of these patients.</p>
dc.identifier.submissionpathqhs_pp/340
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pagesc147-55


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