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Vol. 220. Issue 9.
Pages 537-610 (December 2020)
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Vol. 220. Issue 9.
Pages 537-610 (December 2020)
Original article

Renal function at admission as a prognostic marker for patients hospitalized for a first episode of heart failure. Results of the PREDICE study

Función renal al ingreso como marcador pronóstico en pacientes hospitalizados por un primer episodio de insuficiencia cardíaca. Resultados del estudio predice
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Á. Torralba-Moróna,
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angelito_torralba@hotmail.com

Corresponding author.
, J.M. Guerra-Valesa,b, F.J. Medrano-Ortegac,e, M.A. Navarro-Puertod, D. Lora-Pablosb,e,f, I. Marín-Leónc,e, E. Calderón-Sandubetec,e, A. Gómez-de la Cámarab,e,f
a Servicio de Medicina Interna, HospitalUniversitario 12 de Octubre, Madrid, Spain
b Instituto de Investigación, HospitalUniversitario 12 de Octubre, Madrid, Spain
c Servicio de Medicina Interna, HospitalUniversitario Virgen del Rocío, Sevilla, Spain
d Servicio de Medicina Interna, HospitalUniversitario Nuestra Señora de Valme, Sevilla, Spain
e CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
f Unidad de Investigación Clínica, HospitalUniversitario 12 de Octubre, Spain
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Abstract
Background and objectives

Heart failure (HF) is a frequent condition that deteriorates quality of life and results in high morbidity and mortality. A considerable number of studies have been implemented in recent years to determine the factors that affect the prognosis of HF; however, few studies have assessed the prognosis of patients hospitalised for their first episode of HF. The aim of our study was to analyse the prognostic impact of renal function on patients hospitalised for a first episode of HF.

Material and Methods

We recruited 600 patients hospitalised for a first episode of HF in 3 tertiary Spanish hospitals. We analysed the mortality risk during the first year of follow-up according to renal function at the time of admission.

Results

The patients with the highest degree of kidney failure at admission were older (p < .001), were more often women (p = .01) and presented a higher degree of dependence (p < .05), as well as a higher prevalence of arterial hypertension (p < .001), chronic renal failure (p < .001) and anaemia (p < .001). In the multivariate analysis, the degree of kidney failure at admission remained an independent predictor of increased mortality risk during the first year of follow-up.

Conclusions

The presence of kidney failure at admission was a marker of poor prognosis in our cohort of patients hospitalised for a first episode of HF

Keywords:
Heart failure
Kidney failure
Estimated glomerular filtration rate
Mortality
Resumen
Antecedentes y objetivo

La insuficiencia cardíaca (IC) es una enfermedad frecuente que deteriora la calidad de vida de los pacientes que la padecen y condiciona una elevada morbi-mortalidad. En los últimos años se están desarrollando gran cantidad de trabajos para determinar qué factores influyen en el pronóstico de la IC. Sin embargo, son escasos los que evalúan el pronóstico de los pacientes hospitalizados por su primer episodio de IC. El objetivo de nuestro estudio es analizar el impacto pronóstico de la función renal en pacientes hospitalizados por un primer episodio de IC.

Materiales y métodos

Se recogieron 600 pacientes hospitalizados por un primer episodio de IC en tres hospitales españoles de tercer nivel. Se analizó el riesgo de mortalidad durante el primer año de seguimiento en función del grado de función renal en el momento del ingreso.

Resultados

Los pacientes con mayor grado de insuficiencia renal en el momento del ingreso presentaban edad más avanzada (p < 0,001), eran más frecuentemente mujeres (p = 0,01), presentaban un mayor grado de dependencia (p < 0,05) y mayor prevalencia de hipertensión arterial (p < 0,001), insuficiencia renal crónica (p < 0,001) y anemia (p < 0,001). En el análisis multivariante, el grado de insuficiencia renal al ingreso se mantuvo como predictor independiente de mayor riesgo de mortalidad durante el primer año de seguimiento.

Conclusiones

la presencia de insuficiencia renal en el momento del ingreso es un marcador de mal pronóstico en nuestra cohorte de pacientes hospitalizados por un primer episodio de IC.

Palabras Clave:
Insuficiencia cardíaca
Insuficiencia renal
Filtrado glomerular estimado
Mortalidad

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