Tubular damage and worsening renal function in chronic heart failure

Kevin Damman, Serge Masson, Hans L. Hillege, Adriaan A. Voors, Dirk J. van Veldhuisen, Patrick Rossignol, Gianni Proietti, Savino Barbuzzi, Gian Luigi Nicolosi, Luigi Tavazzi, Aldo P. Maggioni, Roberto Latini

Research output: Contribution to journalArticle

49 Citations (Scopus)

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 languageEnglish
Pages (from-to)417-424
Number of pages8
JournalJACC: Heart Failure
Volume1
Issue number5
DOIs
Publication statusPublished - Oct 2013

Fingerprint

Heart Failure
Kidney
Hexosaminidases
Wounds and Injuries
Mortality
Omega-3 Fatty Acids
Glomerular Filtration Rate
Hospitalization
Morbidity

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

Damman, K., Masson, S., Hillege, H. L., Voors, A. A., van Veldhuisen, D. J., Rossignol, P., ... Latini, R. (2013). Tubular damage and worsening renal function in chronic heart failure. JACC: Heart Failure, 1(5), 417-424. https://doi.org/10.1016/j.jchf.2013.05.007

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 journalArticle

Damman, K, Masson, S, Hillege, HL, Voors, AA, van Veldhuisen, DJ, Rossignol, P, Proietti, G, Barbuzzi, S, Nicolosi, GL, Tavazzi, L, Maggioni, AP & Latini, R 2013, 'Tubular damage and worsening renal function in chronic heart failure', JACC: Heart Failure, vol. 1, no. 5, pp. 417-424. https://doi.org/10.1016/j.jchf.2013.05.007
Damman K, Masson S, Hillege HL, Voors AA, van Veldhuisen DJ, Rossignol P et al. Tubular damage and worsening renal function in chronic heart failure. JACC: Heart Failure. 2013 Oct;1(5):417-424. https://doi.org/10.1016/j.jchf.2013.05.007
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. / Tubular damage and worsening renal function in chronic heart failure. In: JACC: Heart Failure. 2013 ; Vol. 1, No. 5. pp. 417-424.
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AU - Rossignol, Patrick

AU - Proietti, Gianni

AU - Barbuzzi, Savino

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