Highlights
- •We assessed risk factors for acute worsening renal function in HF patients.
- •Hypertension is associated with AWRF in both HFpEF and HFrEF patients.
- •A history of hypertension was important as a risk factor for AWRF in HFpEF.
- •On the other hand, high blood pressure at admission was important in HFrEF.
- •Calcium channel blocker was an independent risk factor in HFpEF, but not in HFrEF.
Abstract
Objective
We compared the risk factors for acute worsening renal function (AWRF) in patients
with acute decompensated heart failure with preserved ejection fraction (HFpEF) versus
those with reduced ejection fraction (HFrEF).
Methods
We retrospectively studied 181 consecutive patients. AWRF was defined as a rise in
serum creatinine of ≥0.3 mg/dL from admission to day 3. Potential risk factors of AWRF were identified
in univariate analyses; then logistic regression analysis with backward stepwise selection
was performed.
Results
In the present study of limited sample size, 46% had HFpEF (EF ≥ 50%) and 54% had HFrEF (EF < 50%). In the HFpEF group, history of hypertension (odds ratio [OR] 32.46, 95% CI 2.39–440.12,
P = 0.009), the increased serum potassium value at admission (OR 4.61, 95% CI 1.14–18.73,
P = 0.032), and the pretreatment with calcium channel blocker (OR 8.52, 95% CI 1.21–60.09,
P = 0.032) were independent risk factors (defined as P < 0.05 and OR > 1.01) for AWRF. In contrast, diastolic blood pressure at admission (OR 1.07, 95% CI
1.02–1.13, P = 0.004) was the sole independent risk factor for AWRF in the HFrEF group.
Conclusions
Hypertension was associated with AWRF in both HFpEF and HFrEF patients. A history
of hypertension was more important than elevated blood pressure at admission as a
risk factor for AWRF in HFpEF, whereas the reverse was observed for HFrEF. Among antihypertensive
drugs, pretreatment with calcium channel blocker was an independent risk factor for
AWRF in HFpEF, but not in HFrEF.
Keywords
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Article info
Publication history
Published online: August 19, 2015
Accepted:
August 5,
2015
Received in revised form:
August 4,
2015
Received:
May 2,
2015
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
