Heart failure tied to poor renal outcome risk
Heart failure (HF) is associated with higher risk of poor renal outcomes, such as incident chronic kidney disease (CKD) and rapid drop in estimated glomerular filtration rate (eGFR), in patients with normal kidney function, a new study reveals.
Baseline information and medication exposure and compliance of 156,743 US veterans were collected. All participants had eGFR ≥60 mL min-1 1.73 m-2 and congestive HF. Study outcomes were incident CKD, rate of kidney function decline and a composite of incident CKD and mortality.
Over a median follow-up of 7.6 years, a total of 361,488 CKD events in the cohort were recorded, yielding an event rate of 16.04 per 1,000 patient-years. The CKD event rate was higher in veteran HF patients (68.90 per 1,000 person-years) than in those without (14.48 per 1,000 person-years).
Multivariate analysis showed a positive association between incident CKD and HF (hazard ratio [HR], 2.12; 95 percent CI, 2.10 to 2.14).
For the composite outcome, 986,588 events were reported. The incidence rates were again higher in HF patients (164.66 per 1,000 person-years) than in non-HF veterans (40.20 per 1,000 person-years). A positive association between HF and the composite outcome was also calculated (HR, 2.06; 2.05 to 2.08).
The overall prevalence of rapid eGFR decline was 9.12 percent and was higher in patients with HF (21.69 percent) than in those without (8.56 percent). Rapid eGFR decline was also positively associated with incident CKD (HR, 2.13; 2.10 to 2.17).