Academic Journal
The difference between cystatin C‐ and creatinine‐based assessment of kidney function in acute heart failure
| العنوان: | The difference between cystatin C‐ and creatinine‐based assessment of kidney function in acute heart failure |
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| المؤلفون: | Pinsino, Alberto, Fabbri, Matteo, Braghieri, Lorenzo, Bohn, Bruno, Gaudig, Antonia J., Kim, Andrea, Takeda, Koji, Naka, Yoshifumi, Sayer, Gabriel T., Uriel, Nir, Demmer, Ryan T., Faillace, Robert T., Husain, Syed A., Mohan, Sumit, Colombo, Paolo C., Yuzefpolskaya, Melana |
| المصدر: | ESC Heart Failure ; volume 9, issue 5, page 3139-3148 ; ISSN 2055-5822 2055-5822 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2022 |
| المجموعة: | Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: | Aims Acute heart failure (HF) is associated with muscle mass loss, potentially leading to overestimation of kidney function using serum creatinine‐based estimated glomerular filtration rate (eGFR sCr ). Cystatin C‐based eGFR (eGFR CysC ) is less muscle mass dependent. Changes in the difference between eGFR CysC and eGFR sCr may reflect muscle mass loss. We investigated the difference between eGFR CysC and eGFR sCr and its association with clinical outcomes in acute HF patients. Methods and results A post hoc analysis was performed in 841 patients enrolled in three trials: Diuretic Optimization Strategy Evaluation (DOSE), Renal Optimization Strategies Evaluation (ROSE), and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS‐HF). Intra‐individual differences between eGFRs (eGFR diff ) were calculated as eGFR CysC –eGFR sCr at serial time points during HF admission. We investigated associations of (i) change in eGFR diff between baseline and day 3 or 4 with readmission‐free survival up to day 60; (ii) index hospitalization length of stay (LOS) and readmission with eGFR diff at day 60. eGFR CysC reclassified 40% of samples to more advanced kidney dysfunction. Median eGFR diff was −4 [−11 to 1.5] mL/min/1.73 m 2 at baseline, became more negative during admission and remained significantly different at day 60. The change in eGFR diff between baseline and day 3 or 4 was associated with readmission‐free survival (adjusted hazard ratio per standard deviation decrease in eGFR diff : 1.14, P = 0.035). Longer index hospitalization LOS and readmission were associated with more negative eGFR diff at day 60 (both P ≤ 0.026 in adjusted models). Conclusions In acute HF, a marked difference between eGFR CysC and eGFR sCr is present at baseline, becomes more pronounced during hospitalization, and is sustained at 60 day follow‐up. The change in eGFR diff during HF admission and eGFR diff at day 60 are associated with clinical outcomes. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1002/ehf2.13975 |
| الاتاحة: | http://dx.doi.org/10.1002/ehf2.13975 https://onlinelibrary.wiley.com/doi/pdf/10.1002/ehf2.13975 https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ehf2.13975 |
| Rights: | http://creativecommons.org/licenses/by-nc/4.0/ |
| رقم الانضمام: | edsbas.18C93677 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1002/ehf2.13975 |
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