title: Predictors of Worsening Renal Function in Patients With Acute Decompensated Heart Failure Treated by Low-Dose Carperitide.
abstract: BACKGROUND
  Predictors of worsening renal function (WRF: increase in serum creatinine ≥ 0.3 mg/dl from the value on admission) in patients with acute decompensated heart failure (ADHF) treated by low-dose carperitide (0.01-0.05 μg/kg/min) are unclear.
  
  
  RESULTS
  We retrospectively investigated predictors of WRF within the first 24 h of low-dose carperitide therapy in 205 patients (mean age, 75.6 ± 12.1 years) hospitalized for ADHF and treated with low-dose carperitide between January 2006 and April 2014. WRF occurred in 14 patients (7%). A multivariate adjustment analysis showed that independent predictors of WRF within 24 h were hypotension (systolic blood pressure <90 mmHg) within 12 h (odds ratio, 8.7; 95% confidence interval, 2.38-35.88; P=0.0012) and serum creatinine on admission (odds ratio, 3.64; 95% confidence interval, 1.84-7.67; P=0.0003). In patients with estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2), the rate of WRF occurrence was higher in those complicated by hypotension than in those without hypotension (22.6% [7/31 patients] vs. 4.4% [5/113 patients], P=0.0041). In contrast, in patients with eGFR ≥ 60 ml/min/1.73 m(2), hypotension did not influence the occurrence of WRF (0% [0/9 patients] vs. 3.9% [2/51 patients], P=NS).
  
  
  CONCLUSIONS
  Hypotension within 12 h and renal dysfunction on admission are independent predictors of WRF within 24 h in patients with ADHF treated by low-dose carperitide. Hypotension may not cause WRF in patients with eGFR ≥ 60 ml/min/1.73 m(2).
authors.affiliation: Department of Cardiovascular Medicine, Kurashiki Central Hospital.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kawase
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Reo
authors.initials: R
authors.lastname: Hata
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Iwasaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Maruo
authors.forename: Harumi
authors.initials: H
authors.lastname: Katoh
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mitsudo
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage*; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: C472955:NPPA protein, human; D009320:Atrial Natriuretic Factor; D003404:Creatinine