1. Incidence of clinical outcomes in heart failure patients with and without advanced chronic kidney disease.
- Author
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Zahir Anjum, Deewa, Bonde, Anders N., Fosbol, Emil, Hartwell Garred, Caroline, Gislason, Gunnar, Elmegaard, Mariam, Knigge, Pauline, Torp‐Pedersen, Christian, Andersson, Charlotte, Pfeffer, Marc A., Jhund, Pardeep S., McMurray, John J.V., Petrie, Mark C., Kober, Lars, and Schou, Morten
- Subjects
CHRONIC kidney failure ,HEART failure patients ,GLOMERULAR filtration rate ,EPIDERMAL growth factor receptors ,HEART failure - Abstract
Aims: Chronic kidney disease (CKD) is a well‐established risk factor for heart failure (HF); however, patients with an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 have been systematically excluded from clinical trials. This study investigated the incidence of HF and kidney outcomes in HF patients with and without advanced CKD, that is, eGFR < 30. Methods: From nationwide registries, HF patients were identified from 2014 to 2018 and categorized into three groups according to baseline eGFR (eGFR ≥ 60, 60 > eGFR ≥ 30 and eGFR < 30). The incidence of primary outcomes (all‐cause mortality, HF hospitalization, end‐stage kidney disease and sustained 50% eGFR decline) was estimated using cumulative incidence functions. Results: Of the 21 959 HF patients included, the median age was 73.9 years, and 30% of patients had an eGFR between 30 and 60 and 7% had an eGFR < 30. The 4 year incidence of all‐cause mortality was highest for patients with eGFR < 30 (28.3% for patients with eGFR ≥ 60, 51.6% for patients with 60 > eGFR ≥ 30 and 72.2% for patients with eGFR < 30). The 4 year incidence of HF hospitalization was comparable between the groups (25.8%, 29.8% and 26.1% for patients with eGFR ≥ 60, 60 > eGFR ≥ 30 and eGFR < 30, respectively). For patients with eGFR < 30, kidney outcomes were four times more often the first event than patients with eGFR > 30 (4 year incidence of kidney outcome as the first event was 5.0% for eGFR ≥ 60, 4.8% for 60 > eGFR ≥ 30 and 20.1% for eGFR < 30). Conclusions: Patients with advanced CKD had a higher incidence of mortality and poorer kidney outcomes than those without advanced CKD, but a similar incidence of HF hospitalizations. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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