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| The relationship between renal dysfunction and death in ICU patients with acute decompensated heart failure |
| Xu Lei, Pei Dong, Zhan Peng, Huang Qing, Xiong Hong-fang, Wang Yuan-fen |
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Abstract Objective To evaluate the associativity between renal dysfunction and long-term mortality of cardiovascular disease in patients with acute decompensated heart failure (ADHF) treated by intensive care unit (ICU). Methods A total of 428 patients with ADHF were selected. The patients were divided into worsening renal function group (WRF group, n=168) and no worsening renal function group (non-WRF group, n=260) according to whether WRF occurred during ICU treatment. The demographic data, clinical data and laboratory data and cumulative survival were compared between the two groups. The patients were followed up, and the Cox proportional hazards model was used to assess the relationship between WRF and all-cause mortality or cardiovascular mortality. Results 168 (39.2%) patients of the 428 patients had WRF. The cardiovascular mortality (19.6% vs. 8.1%, P<0.001) and all-cause mortality (28.6% vs. 15.4%, P<0.001) in the WRF group were significantly higher than those in the non-WRF group. Multivariate Cox proportional hazards model showed that age, serum BNP levels were significantly associated with all-cause death (age: HR=1.125, 95%CI 1.042～1.236, P=0.006; BNP: HR=1.005, 95%CI 1.002～1.011, P=0.026) and cardiovascular death (age: HR=1.132, 95%CI 1.036～1.263, P=0.011;BNP: HR=1.008, 95%CI 1.002～1.035, P=0.030). Conclusion The worsening renal function is associated with cardiovascular death in patients with acute decompensated heart failure. WRF may be one of the criteria for determining follow-up after discharge from patients with acute decompensated heart failure.
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Received: 17 May 2017
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