Abstract
| Lingua originale | English |
|---|---|
| pagine (da-a) | 965-972 |
| Numero di pagine | 8 |
| Rivista | INTERNAL AND EMERGENCY MEDICINE |
| Volume | 10 |
| Stato di pubblicazione | Published - 2015 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Internal Medicine
- Emergency Medicine
Cita questo
Blood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction. / Pinto, Antonio; Paterna, Salvatore; Almasio, Pier Luigi; Parrinello, Gaspare; Torres, Daniele; Bellanca, Michele; Pizzo, Giuseppina Maria; Cuttitta, Francesco; Butler, Javed; Testani, Jeffrey M.
In: INTERNAL AND EMERGENCY MEDICINE, Vol. 10, 2015, pag. 965-972.Risultato della ricerca: Article
}
TY - JOUR
T1 - Blood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction
AU - Pinto, Antonio
AU - Paterna, Salvatore
AU - Almasio, Pier Luigi
AU - Parrinello, Gaspare
AU - Torres, Daniele
AU - Bellanca, Michele
AU - Pizzo, Giuseppina Maria
AU - Cuttitta, Francesco
AU - Butler, Javed
AU - Testani, Jeffrey M.
PY - 2015
Y1 - 2015
N2 - Renal dysfunction (RD) and venous congestion are related and common in heart failure (HF). Studies suggest that venous congestion may be the primary driver of RD in HF. In this study, we sought to investigate retrospectively the relationship between common measures of renal function with caval congestion and mortality among outpatients with HF and RD. We reviewed data from 103 HF outpatients (45 males, mean age 74 years, ejection fraction 41.8 ± 11.6 %) with estimated glomerular filtration rate (eGFR) of <60 ml/min in a single centre. During an ambulatory visit, all patients underwent blood test and ultrasonography of the inferior vena cava (IVC). Caval congestion was defined as IVC with both dilatation and impaired collapsibility. The best values of renal metrics in predicting caval congestion were determined with receiver-operating characteristic analysis. The BUN/Cr ratio is moderately correlated with IVC expiratory maximum diameter (r = 0.31, p < 0.0007). In a multiple logistic regression model, BUN/Cr >25.5 (adjusted OR 2.98, p 0.015) and eGFR ≤45.8 (adjusted OR 5.38, p 0.002) identify patients at risk for caval congestion; a BUN/Cr >23.7 was the best predictor of impaired collapsibility (adjusted OR 4.41, p 0.001). a BUN/Cr >25.5 (HR 2.19, 95 % CI 1.21-3.94, p < 0.001) and NYHA class 3 (HR 2.91, 95 % CI 1.60-5.31, p < 0.0005) were independent risk factors associated with all-cause death during a median follow-up of 31 months. In outpatients with HF and RD, a higher BUN/Cr and lower eGFR are reliable renal biomarkers for caval congestion. The BUN/Cr is associated with long-term mortality and may help to stratify HF severity.
AB - Renal dysfunction (RD) and venous congestion are related and common in heart failure (HF). Studies suggest that venous congestion may be the primary driver of RD in HF. In this study, we sought to investigate retrospectively the relationship between common measures of renal function with caval congestion and mortality among outpatients with HF and RD. We reviewed data from 103 HF outpatients (45 males, mean age 74 years, ejection fraction 41.8 ± 11.6 %) with estimated glomerular filtration rate (eGFR) of <60 ml/min in a single centre. During an ambulatory visit, all patients underwent blood test and ultrasonography of the inferior vena cava (IVC). Caval congestion was defined as IVC with both dilatation and impaired collapsibility. The best values of renal metrics in predicting caval congestion were determined with receiver-operating characteristic analysis. The BUN/Cr ratio is moderately correlated with IVC expiratory maximum diameter (r = 0.31, p < 0.0007). In a multiple logistic regression model, BUN/Cr >25.5 (adjusted OR 2.98, p 0.015) and eGFR ≤45.8 (adjusted OR 5.38, p 0.002) identify patients at risk for caval congestion; a BUN/Cr >23.7 was the best predictor of impaired collapsibility (adjusted OR 4.41, p 0.001). a BUN/Cr >25.5 (HR 2.19, 95 % CI 1.21-3.94, p < 0.001) and NYHA class 3 (HR 2.91, 95 % CI 1.60-5.31, p < 0.0005) were independent risk factors associated with all-cause death during a median follow-up of 31 months. In outpatients with HF and RD, a higher BUN/Cr and lower eGFR are reliable renal biomarkers for caval congestion. The BUN/Cr is associated with long-term mortality and may help to stratify HF severity.
UR - http://hdl.handle.net/10447/163940
M3 - Article
VL - 10
SP - 965
EP - 972
JO - INTERNAL AND EMERGENCY MEDICINE
JF - INTERNAL AND EMERGENCY MEDICINE
SN - 1970-9366
ER -