Elevated blood urea nitrogen-to-creatinine ratio increased the risk of hospitalization and all-cause death in patients with chronic heart failure.
OBJECTIVE
To examine the relationship between blood urea nitrogen (BUN)-to-creatinine ratio and the prognosis of chronic heart failure (HF).


METHODS
We analyzed the data from the cohort of 243 adult patients with chronic HF followed at the HF clinic in a tertiary medical center between December 2003 and June 2006. Primary endpoints were the events of all-cause death and first hospitalization for HF.


RESULTS
During a median follow-up of 1.2 years, 72 events were recorded with an event rate of 25.7 events per 100 person-years. In multivariate-adjusted Cox regression models, elevated BUN-to-creatinine ratio was associated with a heightened risk of hospitalization and all-cause death [hazard ratio (HR), 1.24; 95% confidence interval (CI), 1.02-1.51]. The relationship remained after adjusting for glomerular filtration rate (GFR) (HR, 1.23; 95% CI, 1.01-1.51). There was a linear trend toward increasing risks of adverse outcomes across the tertiles of BUN-to-creatinine ratio (P = 0.02). The coexisting presence of the third tertile of BUN-to-creatinine ratio and GFR < 60 ml/min/1.73 m(2) tended to pose a synergistic risk for hospitalization and all-cause death (relative risk, 2.29), relative to those at the first and second tertiles who had GFR > or = 60 ml/min/1.73 m(2).


CONCLUSIONS
An elevated BUN-to-creatinine ratio, independent of GFR, confers an increased risk of hospitalization and all-cause death in patients with chronic HF.
Lin
Hung-Ju
HJ
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. hungjulin@ntu.edu.tw
Chao
Chia-Lun
CL
Chien
Kuo-Liong
KL
Ho
Yi-Lwun
YL
Lee
Chii-Ming
CM
Lin
Yen-Hung
YH
Wu
Yen-Wen
YW
Hsu
Ron-Bin
RB
Chou
Nai-Kuan
NK
Wang
Shoei-Shen
SS
Chen
Ching-Yi
CY
Chen
Ming-Fong
MF
D000368:Aged; D015415:Biomarkers / Q000652:urine; D001806:Blood Urea Nitrogen; D002423:Cause of Death; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology
D015415:Biomarkers; D003404:Creatinine