title: Long-term changes in renal function and perfusion in heart failure patients with reduced ejection fraction.
abstract: BACKGROUND
  Little is known about the natural course of renal function and renal hemodynamics in heart failure patients with reduced ejection fraction (HFREF).
  
  
  RESULTS
  We prospectively studied effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) in 73 HFREF patients with (125)I-iothalamate/(131)I-hippuran clearances with a mean follow-up of 34.6 ± 4.4 months. Fifteen percent were female, with age 58 ± 12 years and left ventricular ejection fraction (LVEF) 29 ± 10%. Baseline GFR was 81 ± 23 mL/min/1.73 m(2) and declined 0.6 ± 4.7 mL/min/1.73 m(2) per year. Baseline ERPF was 292 ± 83 mL/min/1.73 m(2) and declined 4.3 ± 19 mL/min/1.73 m(2) per year. Of the baseline variables, older age and high urinary kidney injury molecule-1 were the only variables associated with GFR decline (p < 0.05). Following stepwise backward analysis, only age (p < 0.001) remained significant. In addition, we found an association between change in GFR and changes in ERPF, N-terminal pro-brain natriuretic peptide and renovascular resistance. In the multivariable analysis, only the change in ERPF remained significantly associated with a change in GFR (p < 0.001).
  
  
  CONCLUSIONS
  In this cohort of stable chronic HFREF patients, the average decline in GFR over time was small. The decline of GFR was associated with a higher age and a lower baseline GFR, and was strongly related to changes in renal perfusion.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. nicolasschroten@gmail.com.
authors.forename: Nicolas F
authors.initials: NF
authors.lastname: Schroten
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Kevin
authors.initials: K
authors.lastname: Damman
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Mattia A E
authors.initials: MA
authors.lastname: Valente
authors.affiliation: Department of Cardiology, Scheper Ziekenhuis, Emmen, The Netherlands.
authors.forename: Tom D
authors.initials: TD
authors.lastname: Smilde
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Gerjan
authors.initials: G
authors.lastname: Navis
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Gaillard
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. J.L.Hillege@umcg.nl.|Department of Epidemiology, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands. J.L.Hillege@umcg.nl.
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007465:Iodohippuric Acid / Q000493:pharmacokinetics; D007483:Iothalamic Acid / Q000493:pharmacokinetics; D007674:Kidney Diseases / Q000209:etiology / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
chemical_list: D007465:Iodohippuric Acid; D007483:Iothalamic Acid
keywords: Biomarkers; Cardiorenal; Heart failure; Kidney; Renal blood flow