Longitudinal change in renal function in patients with idiopathic dilated cardiomyopathy without renal insufficiency at initial diagnosis.
BACKGROUND
Impaired renal function is associated with poor outcomes among patients with chronic heart failure (CHF). However, the long-term changes in renal function in CHF patients without renal insufficiency at initial diagnosis remain unclear.


RESULTS
Retrospective analysis of patients presenting with idiopathic dilated cardiomyopathy (IDCM) from 1984 to 2003 and who had normal renal function defined as estimated creatinine clearance (eCcr)>or=60 ml/min at the first diagnosis. Cumulative event proportions and renal insufficiency defined as eCcr<60 ml/min were calculated by the Kaplan-Meier method. The predictors of renal insufficiency were evaluated by logistic regression analysis. Impaired renal function developed in 20% during an 8-year follow-up and in 50% during a 20-year follow-up. Advanced age at the first diagnosis, high frequency of admissions, and hypotension during the clinical course were associated with the occurrence of impaired renal function. Beta-blocker therapy was a negative predictor of renal insufficiency.


CONCLUSIONS
In patients with IDCM without renal insufficiency at initial diagnosis, worsening renal function occurred during the follow-up period. Frequent admissions, hypotension, and lacking beta-blocker therapy were associated with a poor prognosis in renal function.
Division of Cardiology, Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Japan.
Komei
K
Tanaka
Masahiro
M
Ito
Makoto
M
Kodama
Hiroki
H
Maruyama
Makoto
M
Hoyano
Wataru
W
Mitsuma
Noriaki
N
Iino
Satoru
S
Hirono
Yuji
Y
Okura
Fumitake
F
Gejyo
Naohito
N
Tanabe
Yoshifusa
Y
Aizawa
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007022:Hypotension / Q000150:complications / Q000503:physiopathology; D007668:Kidney / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000209:etiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left / Q000502:physiology
D000319:Adrenergic beta-Antagonists; D003404:Creatinine