DOI: 10.3724/SP.J.1263.2012.04121

Journal of Geriatric Cardiology 2012/9:4 PP.355-360

Chronic kidney disease: an independent risk factor of all-cause mortality for elderly Chinese patients with chronic heart failure

Objective To evaluate the prognostic value of chronic kidney disease (CKD) in elderly Chinese patients with chronic heart failure (CHF). Methods The study consisted of 327 elderly patients with CHF. All-cause mortality was chosen as an endpoint over the median follow-up period of 345 days. Cox regression analysis was used to identify the risk factors of mortality. Results The median age of the entire cohort was 85 years (60-100 years). The mortality for 168 elderly patients with CHF and CKD (51.4% of entire cohort) was 39.9% (67 deaths), which was higher than the mortality for CHF patients without CKD [25.2% (40/159 deaths)] and the mortality for entire cohort with CHF [32.7% (107/327 deaths)]. The Cox regression analysis showed that old age [hazard ratio (HR): 1.033; 95% confidence interval (95% CI): 1.004-1.064], CKD (HR: 1.705; 95% CI: 1.132-2.567), CHF New York Heart Association (NYHA) class IV (HR: 1.913; 95% CI: 1.284-2.851), acute myocardial infarction (AMI) (HR: 1.696; 95% CI: 1.036-2.777), elevated resting heart rate (HR: 1.021; 95% CI: 1.009-1.033), and decreased plasma albumin (HR: 0.883; 95% CI: 0.843-0.925) were independent risk factors of mortality for elderly patients with CHF. Conclusions CKD was an independent risk factor of mortality for elderly Chinese patients with CHF.

Key words:Chronic heart failure,Chronic kidney disease,Risk factor,The aged

ReleaseDate:2014-07-21 16:32:11

1 Mentz RJ, Lewis EF. Epidemiology of Cardiorenal Syndrome. Cardiol Clin 2011; 29: 301-314.

2 Ronco C, McCullough P, Anker SD, et al. Cardio-renal syndromes: report from the consensus conference of the Acute Dialysis Quality Initiative. Eur Heart J 2010; 31: 703-711.

3 Dickstein K, Cohen-Solal A, Filippatos G, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 2008; 29: 2388-2442.

4 Ma YC, Zuo L, Chen JH. Modified Glomerular Filtration Rate Estimating Equation for Chinese Patients with Chronic Kidney Disease. J Am Soc Nephrol 2006; 17: 2937-2944.

5 National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease (2002) Evaluation, classifi cation, and stratification. Am J Kidney Dis 2002; 39: S1-S266.

6 Thygesen K, Alpert JS, White HD, et al. Joint ESC/ACCF/ AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. Circulation 2007; 116: 2634-2653.

7 Fuster V, Rydén LE, Cannom DS, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 2006; 114: E257-E354.

8 SPSS Inc. SPSS Missing Values™ 17.0. Chicago: SPSS Inc. documentation; 2007.

9 Horwich TB, Kalantar-Zadeh K, MacLellan RW, et al. Albumin levels predict survival in patients with systolic heart failure. Am Heart J 2008; 155: 883-889.

10 Liu M, Chan CP, Yan BP, et al. Albumin levels predict survival in patients with heart failure and preserved ejection fraction. Eur J Heart Fail 2012; 14: 39-44.

11 Mimura I, Nishi H, Nishi T, et al. Malnutrition and inflammation determine prognosis of patients with CRS Type 4. Blood Purif 2011; 31: 276-280.

12 Fruhwald FM, Ulmer H, Pacher R, et al. Heart rate and functional impairment are predictors of outcome in heart failure patients in the real world. Data from the Austrian Heart Failure registry. Wien Klin Wochenschr 2011; 123: 378-383.

13 Beddhu S, Nigwekar SU, Ma X, et al. Associations of resting heart rate with insulin resistance, cardiovascular events and mortality in chronic kidney disease. Nephrol Dial Transplant 2009; 24: 2482-2488.