title: Elevated serum C-reactive protein levels as a predictive indicator for subsequent renal impairment in patients with acute heart failure.
abstract: Renal impairment is often observed in acute heart failure (HF), which is an independent prognostic factor. It is important to identify high-risk patients, who need close follow-up and intensive care for renal protection. This study was conducted to identify the factors associated with the subsequent occurrence of HF-related renal dysfunction in patients, who were admitted to the hospitals due to acute HF symptoms. We evaluated 254 consecutive patients with acute HF. HF-related renal dysfunction was defined when highest serum creatinine level was greater than 1.2 mg/dl and the serum creatinine level increased by more than 50% compared with the baseline value during the admission. Forty patients with acute HF (16%) had subsequent renal dysfunction after admission. Elevated serum C-reactive protein (CRP) levels (> or = 5 mg/dl, odds ratio 2.51, p = 0.008 by univariate analysis, odds ratio 2.43, p = 0.019 by multivariate analysis) during the first week after admission and over-reduction of body weight (> or = 4.5 kg, odds ratio 2.68, p = 0.005 by univariate analysis, odds ratio 2.53, p = 0.010 by multivariate analysis) by acute HF treatment were significantly associated with this phenomenon. Patients with high CRP levels (> or = 5 mg/dl) during the first week after admission showed a significantly greater elevation of serum creatinine levels as compared to the levels before admission than those with low CRP levels (< 5 mg/dl). In conclsion, higher serum levels of CRP could predict the subsequent renal impairment in patients admitted with the worsening of HF symptoms.
authors: Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan. fukumoto@cardio.med.tohoku.ac.jp
authors: Yoshihiro
authors: Y
authors: Fukumoto
authors: Takuya
authors: T
authors: Kishi
authors: Hiroyuki
authors: H
authors: Tsutsui
authors: Akira
authors: A
authors: Yamada
authors: Shuichi
authors: S
authors: Okamatsu
authors: Akira
authors: A
authors: Takeshita
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000503:physiopathology; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012044:Regression Analysis
chemical_list: D002097:C-Reactive Protein