Worsening renal function and prognosis in heart failure: Systematic review and meta-analysis
Worsening renal function and prognosis in heart failure: Systematic review and meta-analysis
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DOI：
10.1016/j.cardfail.2007.04.008
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发表时间：
2007-10-01
影响因子：
6
通讯作者：
Hillege, Hans L.
中科院分区：
文献类型：
--
作者：
Damman, Kevin;Navis, Gerjan;Hillege, Hans L.
背景：肾损害与心力衰竭（HF）死亡率增加相关。最近，报告表明，恶化的肾功能（WRF）是另一个预测临床结果的HE本研究的目的是建立比例的HF患者表现出（WRF）和相关的风险，死亡率和住院治疗进行系统的审查和荟萃分析。方法和结果：系统检索MEDLINE发现了8项关于WRF与18，634例HE患者死亡率关系的研究。使用随机效应荟萃分析估计与WRF相关的死亡风险。WRF定义为血清肌酐升高>= 0.2 mg/dL或肾小球滤过率估计值相应降低>= mL.min.1.73（2）。亚组分析包括院内和院外患者之间的差异、WRF程度和至终点发生的时间。4，734例（25%）患者发生WRF，与死亡率（比值比[OR] = 1.62; 95%置信区间[CI] 1.45-1.82，P <0.001）和住院治疗（OR = 1.30，95% CI 1.04-1.62，P = 0.022）的风险较高相关。WRF的严重程度也与更高的死亡率相关。基线时肾功能受损的患者更倾向于进行性肾功能loss.Conclusions：WRF预测HF患者的死亡率和住院率显著升高。
Background: Renal impairment is associated with increased mortality in heart failure (HF). Recently, reports suggest that worsening renal function (WRF) is another predictor of clinical outcome in HE The present study was designed to establish the proportion of patients with HF that exhibits (WRF) and the associated risk for mortality and hospitalization by conducting a systematic review and meta-analysis.Methods and Results: A systematic search of MEDLINE revealed 8 Studies on the relationship between WRF and mortality in 18,634 patients with HE The mortality risk associated with WRF was estimated using random-effects meta-analysis. WRF was defined as an increase in serum creatinine >= 0.2 mg/dL or a corresponding decrease in estimated glomerular filtration rate >= 5 mL.min.1.73 m(2). Subgroup analysis included differentiation between in- and out-hospital patients, degree of WRF and time until end point occurrence. WRF developed in 4,734 (25%) patients and was associated with a higher risk for mortality (odds ratio [OR] = 1.62; 95% confidence interval [CI] 1.45-1.82, P < .001) and hospitalization (OR = 1.30, 95% CI 1.04-1.62, P = .022). The severity of WRF was also associated with greater mortality. Patients with impaired renal function at baseline were more prone to progressive renal function loss.Conclusions: WRF predicts substantially higher rates of mortality and hospitalization in patients with HF.