Document Server@UHasselt >
Research >
Research publications >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/18043

Title: Prognostic Value of Glomerular Filtration Changes Versus Natriuretic Response in Decompensated Heart Failure With Reduced Ejection
Authors: VERBRUGGE, Frederik
NIJST, Petra
DUPONT, Matthias
Reynders, Carmen
Tang, W. H. Wilson
Mullens, Wilfried
Issue Date: 2014
Citation: JOURNAL OF CARDIAC FAILURE, 20 (11), p. 817-824
Abstract: Background: Glomerular filtration rate (GFR) and natriuretic response to diuretics represent important treatment targets in acute decompensated heart failure (ADHF). Methods and Results: Consecutive ADHF patients (n = 50) with ejection fraction <= 45% and clinical signs of volume overload received protocol-driven decongestive therapy. Serum creatinine (Cr), cystatin C (CysC), and beta-trace protein (beta TP) were measured on admission and three subsequent days of treatment. Worsening renal function (WRF) was defined as a >= 0.3 increase in absolute biomarker levels or >= 20% decrease in estimated GFR. Consecutive 24-hour urinary collections were simultaneously performed to measure Cr clearance and natriuresis. Serum Cr, CysC, and beta TP were strongly correlated at admission (p = 0.788-0.909) and during decongestive treatment (p = 0.884-888). Moreover, derived GFR estimates correlated well with Cr clearance (p = 0.820-0.908.). Nevertheless, WRF incidence differed markedly according to Cr- (26%-30%), CysC- (46%-54%), or beta TP-based definitions (31%-48%). WRF by any definition was not associated with all-cause mortality or ADHF readmission, in contrast to stronger natriuresis per loop diuretic dose [hazard ratio 0.20 (95% confidence interval 0.06-0.64); P = .007]. Conclusions: Serial measurements of CysC/beta TP, compared with serum Cr, more frequently indicate WRF during decongestive treatment in ADHF. However, adverse clinical outcome in such patients might be better predicted by the natriuretic response to diuretic therapy.
Notes: [Verbrugge, Frederik Hendrik; Nijst, Petra; Dupont, Matthias; Mullens, Wilfred] Ziekenhuis Oost Limburg, Dept Cardiol, B-3600 Genk, Belgium. [Verbrugge, Frederik Hendrik; Nijst, Petra] Hasselt Univ, Doctoral Sch Med & Life Sci, Diepenbeek, Belgium. [Reynders, Carmen; Penders, Joris] Ziekenhuis Oost Limburg, Dept Lab Med, B-3600 Genk, Belgium. [Penders, Joris; Mullens, Wilfred] Hasselt Univ, Fac Med & Life Sci, Biomed Res Inst, Diepenbeek, Belgium. [Tang, W. H. Wilson] Cleveland Clin, Inst Heart & Vasc, Dept Cardiovasc Med, Cleveland, OH 44106 USA.
URI: http://hdl.handle.net/1942/18043
DOI: 10.1016/j.cardfail.2014.08.002
ISI #: 000344837300004
ISSN: 1071-9164
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

Files in This Item:

Description SizeFormat
published version526.57 kBAdobe PDF

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.