Anemia and chronic kidney disease are associated with poor outcomes in heart failure patients.
BACKGROUND
Chronic kidney disease (CKD) has been linked to higher heart failure (HF) risk. Anemia is a common consequence of CKD, and recent evidence suggests that anemia is a risk factor for HF. The purpose of this study was to examine among patients with HF, the association between CKD, anemia and inhospital mortality and early readmission.


METHODS
We performed a retrospective cohort study in two Swiss university hospitals. Subjects were selected based the presence of ICD-10 HF codes in 1999. We recorded demographic characteristics and risk factors for HF. CKD was defined as a serum creatinine > or = 124 956;mol/L for women and > or = 133 micromol/L for men. The main outcome measures were inhospital mortality and thirty-day readmissions.


RESULTS
Among 955 eligible patients hospitalized with heart failure, 23.0% had CKD. Twenty percent and 6.1% of individuals with and without CKD, respectively, died at the hospital (p < 0.0001). Overall, after adjustment for other patient factors, creatinine and hemoglobin were associated with an increased risk of death at the hospital, and hemoglobin was related to early readmission.


CONCLUSIONS
Both CKD and anemia are frequent among older patients with heart failure and are predictors of adverse outcomes, independent of other known risk factors for heart failure.
Luthi
Jean-Christophe
JC
Institute of Social and Preventive Medicine, University of Lausanne, Switzerland. jean-christophe.luthi@chuv.ch
Flanders
W Dana
WD
Burnier
Michel
M
Burnand
Bernard
B
McClellan
William M
WM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000453:epidemiology; D002303:Cardiac Output, Low / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D002908:Chronic Disease; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D017052:Hospital Mortality; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission; D015995:Prevalence; D012189:Retrospective Studies
D006454:Hemoglobins; D003404:Creatinine