Decreased renal function as an independent predictor of re-hospitalization for congestive heart failure. |
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Authors: | Kimiaki Komukai Takayuki Ogawa Hidenori Yagi Taro Date Hiroshi Sakamoto Yasuko Kanzaki Kenri Shibayama Koichi Hashimoto Keiichi Inada Kosuke Minai Kazuo Ogawa Tsuneharu Kosuga Makoto Kawai Kenichi Hongo Ikuo Taniguchi Michihiro Yoshimura |
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Institution: | Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. komu@jikei.ac.jp |
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Abstract: | BACKGROUND: Patients with congestive heart failure (CHF) are often re-hospitalized, worsening both their quality of life and prognosis. Although renal dysfunction reportedly increases the risk of CHF, the association between renal dysfunction and re-hospitalization for CHF remains unclear. METHODS AND RESULTS: Patients with CHF and decreased renal function were reviewed. The estimated glomerular filtration rate (GFR) was calculated with the Modification of Diet in Renal Disease equation. Patients with decreased renal function (estimated GFR on admission <45 ml .min(-1) . 1.73 m(-2)) were re-hospitalized more frequently than were patients with preserved renal function (estimated GFR on admission >or=45). Patients with decreased renal function were older and had higher rates of anemia, worsening renal function during hospitalization, and previous hospitalization for CHF. Independent predictors of re-hospitalization for CHF identified with multivariate analysis were age, previous hospitalization for CHF, decreased renal function, and non-use of an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker. CONCLUSIONS: Renal dysfunction is an independent predictor of re-hospitalization for CHF, so careful follow-up is needed, even after discharge. |
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