[Renal dysfunction and survival in hospitalized patients with chronic heart failure: a retrospective analysis].
OBJECTIVE
To analyze the impact of renal dysfunction on survival in hospitalized chronic heart failure (CHF) patients.


METHODS
In this retrospective analysis, we collected all clinical data from eligible patients hospitalized in the second hospital of Tianjin Medical University between Jan 1980 and Aug 2007. CHF patients were divided into three groups according to glomerular filtration rate (GFR): A, normal renal function; B, mild renal dysfunction; C, renal dysfunction. Patients in group C were further divided into three subgroups according to hospitalization year: D, 1980.01 - 1989.12; E, 1990.01 - 1999.12; F, 2000.01 - 2007.08.


RESULTS
Renal dysfunction was found in 714 patients. Compared with group A (n = 817) and group B (n = 928), patients in group C were older, had worse heart function and major medications included nitrates, diuretics and digitalis. From 1980 to 2007, use of Angiotensin II receptor antagonist, beta-blocker, statins significantly increased and the in-hospital mortality significantly decreased in group C patients. Percent of angiotensin converting enzyme inhibitor (ACEI) use was the highest in 1990s. The hospital stay was significantly longer and all cause in-hospital mortality was significantly higher in group C compared to group A and group B (all P < 0.01). After adjustment for other risk factors by multivariate analysis, renal dysfunction was an independent risk factor of in-hospital all cause mortality. Patients faced 16.7% higher risk of all cause in-hospital mortality for every 10 mlxmin(-1) x1.73 m(-2) decrease in GFR.


CONCLUSIONS
The incidence of renal dysfunction was high in CHF patients. The hospital stay was longer, in-hospital all-cause mortality was higher in CHF patients with renal dysfunction compared to CHF patients without or with mild renal dysfunction. Renal dysfunction was an independent risk factor for all-cause in-hospital mortality. Increased use of ACEI, ARB, beta-blocker and statins might be responsible for reduced in-hospital mortality in CHF with renal dysfunction patients in recent years.
Yang
Yan-hua
YH
Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Wang
Lin
L
An
Fang
F
Huang
Jiao-hong
JH
Ma
Jin-ping
JP
Li
Guang-ping
GP
Li
Li-feng
LF
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051437:Renal Insufficiency; D012189:Retrospective Studies; D016019:Survival Analysis