Decreased renal function as an independent predictor of re-hospitalization for congestive heart failure.
BACKGROUND
Patients with congestive heart failure (CHF) are often re-hospitalized, worsening both their quality of life and prognosis. Although renal dysfunction reportedly increases the risk of CHF, the association between renal dysfunction and re-hospitalization for CHF remains unclear.


RESULTS
Patients with CHF and decreased renal function were reviewed. The estimated glomerular filtration rate (GFR) was calculated with the Modification of Diet in Renal Disease equation. Patients with decreased renal function (estimated GFR on admission <45 ml .min(-1) . 1.73 m(-2)) were re-hospitalized more frequently than were patients with preserved renal function (estimated GFR on admission >or=45). Patients with decreased renal function were older and had higher rates of anemia, worsening renal function during hospitalization, and previous hospitalization for CHF. Independent predictors of re-hospitalization for CHF identified with multivariate analysis were age, previous hospitalization for CHF, decreased renal function, and non-use of an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker.


CONCLUSIONS
Renal dysfunction is an independent predictor of re-hospitalization for CHF, so careful follow-up is needed, even after discharge.
Komukai
Kimiaki
K
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. komu@jikei.ac.jp
Ogawa
Takayuki
T
Yagi
Hidenori
H
Date
Taro
T
Sakamoto
Hiroshi
H
Kanzaki
Yasuko
Y
Shibayama
Kenri
K
Hashimoto
Koichi
K
Inada
Keiichi
K
Minai
Kosuke
K
Ogawa
Kazuo
K
Kosuga
Tsuneharu
T
Kawai
Makoto
M
Hongo
Kenichi
K
Taniguchi
Ikuo
I
Yoshimura
Michihiro
M
D000368:Aged; D000740:Anemia / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors