title: Baseline albumin is associated with worsening renal function in patients with acute decompensated heart failure receiving continuous infusion loop diuretics.
abstract: OBJECTIVE
  To identify baseline predictors of worsening renal function (WRF) in an acute decompensated heart failure (ADHF) patient population receiving continuous infusion loop diuretics.
  
  
  METHODS
  Retrospective observational analysis.
  
  
  METHODS
  Academic tertiary medical center.
  
  
  METHODS
  A total of 177 patients with ADHF receiving continuous infusion loop diuretics from January 2006 through June 2009.
  
  
  RESULTS
  The mean patient age was 61 years, 63% were male, ~45% were classified as New York Heart Association functional class III, and the median length of loop diuretic infusion was 4 days. Forty-eight patients (27%) developed WRF, and 34 patients (19%) died during hospitalization. Cox regression time-to-event analysis was used to determine the time to WRF based on different demographic and clinical variables. Baseline serum albumin 3 g/dl or less was the only significant predictor of WRF (hazard ratio [HR] 2.87, 95% confidence interval [CI] 1.60-5.16, p=0.0004), which remained significant despite adjustments for other covariates.
  
  
  CONCLUSIONS
  Serum albumin 3 g/dl or less is a practical baseline characteristic associated with the development of WRF in patients with ADHF receiving continuous infusion loop diuretics.
authors.affiliation: Department of Pharmacy Services, Allegheny General Hospital, Pittsburgh, PA 15212, USA. meganmbarnes@me.com
authors.forename: Megan M
authors.initials: MM
authors.lastname: Clarke
authors.forename: Michael P
authors.initials: MP
authors.lastname: Dorsch
authors.forename: Susie
authors.initials: S
authors.lastname: Kim
authors.forename: Keith D
authors.initials: KD
authors.lastname: Aaronson
authors.forename: Todd M
authors.initials: TM
authors.lastname: Koelling
authors.forename: Barry E
authors.initials: BE
authors.lastname: Bleske
mesh_terms: D000046:Academic Medical Centers; D000208:Acute Disease; D000368:Aged; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007262:Infusions, Intravenous; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D013997:Time Factors
chemical_list: D004232:Diuretics; D012709:Serum Albumin