Abstract
BackgroundChronic kidney disease (CKD) has been linked to higher heart failure (HF) risk. Anemia is a common consequence of CKD, and recent evidence suggests that anemia is a risk factor for HF. The purpose of this study was to examine among patients with HF, the association between CKD, anemia and inhospital mortality and early readmission.MethodsWe performed a retrospective cohort study in two Swiss university hospitals. Subjects were selected based the presence of ICD-10 HF codes in 1999. We recorded demographic characteristics and risk factors for HF. CKD was defined as a serum creatinine ≥ 124 956;mol/L for women and ≥ 133 μmol/L for men. The main outcome measures were inhospital mortality and thirty-day readmissions.ResultsAmong 955 eligible patients hospitalized with heart failure, 23.0% had CKD. Twenty percent and 6.1% of individuals with and without CKD, respectively, died at the hospital (p < 0.0001). Overall, after adjustment for other patient factors, creatinine and hemoglobin were associated with an increased risk of death at the hospital, and hemoglobin was related to early readmission.ConclusionBoth CKD and anemia are frequent among older patients with heart failure and are predictors of adverse outcomes, independent of other known risk factors for heart failure.
Highlights
Chronic kidney disease (CKD) has been linked to higher heart failure (HF) risk
Chronic kidney disease (CKD) is a major health problem resulting in considerably increased morbidity, mortality and in high costs [4]
The clinical implication of these findings for patients with HF is that failure to correct severe anemia among patients with CKD confers a preventable burden of reduced quality of life, while clinical trials have demonstrated that correction of anemia improved these measures
Summary
Chronic kidney disease (CKD) has been linked to higher heart failure (HF) risk. The purpose of this study was to examine among patients with HF, the association between CKD, anemia and inhospital mortality and early readmission. Heart failure (HF) is a common and serious condition that affects more than four million people in the United States [1]. 400,000 new cases are diagnosed each year, with mortality 6 years after diagnosis of 80% in men and 65% in women [1]. In Europe, the prevalence of symptomatic heart failure in the general population is estimated to range from 0.4% to 2% [2]. Chronic kidney disease (CKD) is a major health problem resulting in considerably increased morbidity, mortality and in high costs [4].
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