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 |
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Pages (from-to) | 417-424 |
Number of pages | 8 |
Journal | JACC: Heart Failure |
Volume | 1 |
Issue number | 5 |
DOIs | |
Publication status | Published - Oct 2013 |
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)