| アブストラクト | BACKGROUND: This retrospective observational study investigated the incidence of worsening renal function (WRF) in patients hospitalized for heart failure (HF) and treated with intravenous diuretics in Japan.Methods and Results: Associations between WRF at any point and HF treatments, and the effects of WRF on outcomes were evaluated (Diagnosis Procedure Combination database). Of 1,788 patients analyzed (mean [+/-SD] age 80.5+/-10.2 years; 54.4% male), 641 (35.9%) had WRF during a course of hospitalization for worsening HF: 208 (32.4%) presented with WRF before admission (BA-WRF; estimated glomerular filtration rate decreased by >/=25% from baseline at least once between 30 days prior to admission and admission); 44 (6.9%) had WRF that persisted before and after admission (P-WRF); and 389 (60.7%) had WRF develop after admission (AA-WRF). Delayed initial diuretic administration, higher maximum doses of intravenous diuretics during hospitalization, and diuretic readministration during hospitalization were associated with a significantly higher incidence of AA-WRF. Patients with WRF at any time point were at higher risk of death during hospitalization compared with patients without WRF, with adjusted hazard ratios of 3.56 (95% confidence interval [CI] 2.23-5.69) for BA-WRF, 3.23 (95% CI 2.21-4.71) for AA-WRF, and 13.16 (95% CI 8.19-21.15) for P-WRF (all P<0.0001). CONCLUSIONS: Forty percent of WRF occurred before admission for acute HF; there was no difference in mortality between patients with BA-WRF and AA-WRF. |
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| ジャーナル名 | Circulation journal : official journal of the Japanese Circulation Society |
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| 投稿日 | 2023/12/25 |
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| 投稿者 | Shiraishi, Yasuyuki; Kurita, Yuka; Mori, Hiromasa; Oishi, Kazuyuki; Matsukawa, Miyuki |
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| 組織名 | Department of Cardiology, Keio University School of Medicine.;Medical Affairs, Otsuka Pharmaceutical Co., Ltd. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38143082/ |
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