Abstract
Objectives: This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) inchronic heart failure (HF). Background: WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF. Methods: In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers ( N-acetyl-beta- d-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF. Results: A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p<0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariable-adjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p= 0.001). Conclusions: WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336).
| Original language | English |
|---|---|
| Pages (from-to) | 417-424 |
| Number of pages | 8 |
| Journal | JACC: Heart Failure |
| Volume | 1 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 2013 |
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Keywords
- EGFR
- Heart failure
- HF
- KIM
- NAG
- NGAL
- Renal insufficiency
- Tubular damage
- Worsening renal function
- WRF
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
Tubular damage and worsening renal function in chronic heart failure. / Damman, Kevin; Masson, Serge; Hillege, Hans L.; Voors, Adriaan A.; van Veldhuisen, Dirk J.; Rossignol, Patrick; Proietti, Gianni; Barbuzzi, Savino; Nicolosi, Gian Luigi; Tavazzi, Luigi; Maggioni, Aldo P.; Latini, Roberto.
In: JACC: Heart Failure, Vol. 1, No. 5, 10.2013, p. 417-424.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Tubular damage and worsening renal function in chronic heart failure
AU - Damman, Kevin
AU - Masson, Serge
AU - Hillege, Hans L.
AU - Voors, Adriaan A.
AU - van Veldhuisen, Dirk J.
AU - Rossignol, Patrick
AU - Proietti, Gianni
AU - Barbuzzi, Savino
AU - Nicolosi, Gian Luigi
AU - Tavazzi, Luigi
AU - Maggioni, Aldo P.
AU - Latini, Roberto
PY - 2013/10
Y1 - 2013/10
N2 - Objectives: This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) inchronic heart failure (HF). Background: WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF. Methods: In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers ( N-acetyl-beta- d-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF. Results: A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p<0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariable-adjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p= 0.001). Conclusions: WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336).
AB - Objectives: This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) inchronic heart failure (HF). Background: WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF. Methods: In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers ( N-acetyl-beta- d-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF. Results: A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p<0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariable-adjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p= 0.001). Conclusions: WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336).
KW - EGFR
KW - Heart failure
KW - HF
KW - KIM
KW - NAG
KW - NGAL
KW - Renal insufficiency
KW - Tubular damage
KW - Worsening renal function
KW - WRF
UR - http://www.scopus.com/inward/record.url?scp=84885173523&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885173523&partnerID=8YFLogxK
U2 - 10.1016/j.jchf.2013.05.007
DO - 10.1016/j.jchf.2013.05.007
M3 - Article
C2 - 24621973
AN - SCOPUS:84885173523
VL - 1
SP - 417
EP - 424
JO - JACC: Heart Failure
JF - JACC: Heart Failure
SN - 2213-1779
IS - 5
ER -