Prognostic value of formulas estimating excretory renal function in the elderly with systolic heart failure

Domenico Scrutinio, Andrea Passantino, Daniela Santoro, Erasmo Cacciapaglia, Giuseppe Farinola

Research output: Contribution to journalArticlepeer-review

Abstract

Background: reduced renal excretory function (REF) is increasingly being appreciated as a potent prognostic factor in chronic heart failure (CHF). The Cockroft-Gault (CG) and the simplified Modification of Diet in Renal Disease (MDRD) equations have been recommended to estimate REF. However, limitations for both formulas have been reported in the elderly. Their prognostic performance in older CHF patients has not been investigated. Objectives: to assess the factors independently associated with all-cause mortality and compare the prognostic value of formulas estimating REF in CHF patients aged ≥70 years. Design: a longitudinal study with a median follow-up of 859 days. The end-point was all-cause mortality. Setting: Division of Cardiology and Cardiac Rehabilitation. Subjects: two hundred and sixty-six patients aged ≥70 years with systolic CHF. Methods: REF was estimated using the CG (eCrClCG) and the MDRD (eGFRMDRD) formulas. Cox proportional hazards model was used to assess the factors independently associated with mortality and compare the prognostic value of estimating formulas. Receiver-operating characteristic (ROC) curve analysis was also performed. Results: Kaplan-Meier estimates of the rates of death at 1 and 2 years were 85% and 73%, respectively At multivariate analysis, eCrClCG CG was significantly more accurate than the eGFRMDRD. Conclusions: among CHF patients aged ≥70 years, reduced REF is the most powerful independent predictor of survival. The excess in risk conferred by reduced REF is better appraised by means of the CG than the MDRD equation.

Original languageEnglish
Pages (from-to)296-301
Number of pages6
JournalAge and Ageing
Volume38
Issue number3
DOIs
Publication statusPublished - 2009

Keywords

  • Elderly
  • Heart failure
  • Renal dysfunction

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

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