[Deterioration of kidney function as a risk factor for mortality among patients hospitalized for heart failure].
BACKGROUND
Acute deterioration of kidney function among patients admitted to the hospital for cardiac failure is associated with an increased mortality.


OBJECTIVE
To investigate the association between deterioration of kidney function and mortality among patients hospitalized for cardiac failure.


METHODS
Patients admitted for decompensated cardiac failure to 14 Chilean hospitals between 2002 and 2009 were incorporated to the study. Clinical and laboratory features were registered. Serum creatinine values on admission and discharge were determined. Hospital and long term mortality was determined requesting death certificates to the National Identification Service at the end of follow up, lasting 635 ± 581 days.


RESULTS
One thousand sixty four patients were incorporated and 1100, aged 68 ± 13 years (45% females) had information about renal function. Seventy seven percent were hypertensive and 36% were diabetic. Mean ejection fraction was 41 ± 18% and 34% had an ejection fraction over 50%. Mean admission creatinine was 1.7 ± 1.6 mg/dl and 19% had a creatinine over 2 mg/dl. Serum creatinine increased more than 0.5 mg/dl during hospitalization in 9% of general patients and in 11% of diabetics. The increase in creatinine was associated with a higher risk of hospital mortality (odds ratio (OR) 12.9, 95% confidence intervals (CI) 6.7-27.6) and long term mortality (OR 2.1, 95% CI 1.6-3).


CONCLUSIONS
The deterioration of renal function during hospitalization of patients with heart failure is a risk factor for hospital and long term mortality.
Pablo
P
Castro
Hugo
H
Verdejo
Rodrigo
R
Altamirano
Patricio
P
Downey
José Luis
JL
Vukasovic
Luis
L
Sepúlveda
Fernando
F
Lanas
Paola
P
Bilbao
Ricardo
R
Pacheco
Víctor
V
Rossel
D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012042:Registries; D051437:Renal Insufficiency / Q000150:complications / Q000401:mortality* / Q000628:therapy; D012307:Risk Factors; D015996:Survival Rate
D003404:Creatinine