title: Decreased renal function as an independent predictor of re-hospitalization for congestive heart failure.
abstract: 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.
authors.affiliation: 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
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Komukai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ogawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yagi
authors.forename: Taro
authors.initials: T
authors.lastname: Date
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kanzaki
authors.forename: Kenri
authors.initials: K
authors.lastname: Shibayama
authors.forename: Koichi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Keiichi
authors.initials: K
authors.lastname: Inada
authors.forename: Kosuke
authors.initials: K
authors.lastname: Minai
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ogawa
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Kosuga
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hongo
authors.forename: Ikuo
authors.initials: I
authors.lastname: Taniguchi
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: 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