Clinical Study

Worsening Renal Function in Patients Hospitalized with Acute Heart Failure: Risk Factors and Prognostic Significances

Table 1

Characteristics at admission of the whole population and of patients with and without WRF (CRE).

TotalWRF absentWRF present -value
( )( )( )

Demographics
 Age (mean, SD)77.9 (10.1)77.8 (10.3)79.2 (8.4).380
 Age years274 (69.5)239 (68.1)35 (81.4).074
 Males266 (67.5)236 (67.2)30 (69.8).738
Medical history
 Prior heart failure243 (61.7)218 (62.1)25 (58.1).613
 Diabetes130 (33.0)108 (30.8)12 (27.9).700
 Valvular disease108 (27.4)99 (28.2)9 (20.9).313
 COPD122 (30.9)111 (31.6)11 (25.6).418
 Hypertension230 (58.4)201 (57.3)29 (67.4).201
 Peripheral vascular disease (PVD)74 (18.8)67 (19.1)7 (16.3).656
 Previus acute coronary syndrome226 (57.4)204 (58.1)22 (51.2).384
 Prior renal failure95 (24.1)76 (21.6)19 (44.2).001
Clinical and laboratory parameters
 Systolic blood pressure, mm Hg (mean, SD)132 (25.5)131 (25.1)137 (29.1).138
 Systolic blood pressure >160 mm Hg43 (10.9)36 (10.3)7 (16.3).230
 Serum creatinine, mg/dL (mean, SD)1.5 (0.8)1.47 (0.8)1.71 (0.9).066
 Creatinine  mg/dL111 (28.2)92 (26.2)19 (44.2).013
 GFR, mL/min (mean, SD)54 (23.5)55 (22.8)51 (28.4).070
 GFR  mL/min239 (60.7)207 (59.0)32 (74.4).055
 Sodium, mEq/L (mean, SD)140 (4.4)140 (4.5)140 (3.5).854
 Potassium, mEq/L (mean, SD)4.0 (0.6)4.0 (0.6)3.9 (0.6).219
 Glycemia, mg/dL (mean, SD)76 (73.0)78 (74.6)58 (56.6).114
 Haemoglobin, gr/dL (mean, SD)12.6 (6.5)12.7 (1.8)12.1 (6.9).387
 Anaemia (hemoglobin 12 gr/dL)167 (42.4)147 (41.9)20 (46.5).562
 Haematocrit (mean, SD)38 (6.1)39 (6.2)38 (5.2).502
 Azotemia, mg/dL (mean, SD)46 (50.0)45.5 (49.1)50.2 (60.5).561
 NYHA class (mean, SD)3.3 (0.7)3.3 (0.6)3.3 (0.7).778
 NYHA class III-IV353 (89.6)316 (90.0)37 (86.0).420
 KILLIP (mean, SD)2.4 (0.6)2.3 (0.6)2.4 (0.6).363
Doppler echocardiography
 Ejection fraction (mean, SD)39.6 (12.2)39.5 (12.2)39.7 (12.4).942
 Ejection fraction 45%241 (61.2)215 (61.3)26 (60.5).869
 Left atrial size, mm (mean, SD)46.3 (7.3)46.4 (7.5)45.2 (6.0).343
 Left ventricular size, mm (mean, SD)58.5 (9.5)58.4 (10.0)58.1 (6.7).982
 Left atrial dilatation232 (58.9)211 (60.1)21 (48.8).279
 Left ventricular dilatation265 (67.3)237 (67.5)28 (65.1).880
Elettrocardiogram
 LBBB45 (11.4)40 (11.4)5 (11.6).960
 Heart rate, bpm (mean, SD)85.3 (17.0)85 (17.0)88 (16.3).276
 Heart rate  bpm80 (20.3)64 (18.2)16 (37.2).003
 Atrial fibrillation164 (41.6)149 (42.4)15 (34.9).342
Medical treatments
 Aldosterone antagonists88 (22.3)76 (21.6)12 (27.9).352
 Diuretics285 (72.3)255 (72.5)30 (69.8).690
 Beta-blockers109 (27.7)98 (27.9)11 (25.6).746
 Calcium channell blockers60 (15.3)49 (14.0)11 (25.6).045
 ACE inhibitors215 (54.7)190 (54.1)25 (58.1).618
 ARBs37 (9.4)30 (8.5)7 (16.3).101
 Statins46 (11.7)40 (11.4)6 (14.0).865
 ASA163 (41.4)143 (40.7)20 (46.5).468
 Warfarin101 (25.6)91 (25.9)10 (23.3).705
 Nitrates144 (36.5)133 (37.9)11 (25.6).114
 Digoxin99 (25.1)95 (27.1)4 (9.3).006

ACE: angiotensin-converting enzyme; ARBs: angiotensin receptor blockers; ASA: acetylsalycilic acid; LBBB: left bundle branch block; COPD: chronic obstructive pulmunary disease; NYHA: New York Health Association.