Chronic Kidney Disease

HF Hospitalization, Rehospitalization Is Common Among Patients With CKD

Individuals with chronic kidney disease (CKD) have a high likelihood of being hospitalized and rehospitalized for heart failure (HF), according to new research. And those who are hospitalized have a greater risk for CKD progression as well as mortality, the study authors say.

To examine the HF hospitalization and rehospitalization rates among patients with CKD, the investigators for the prospective Chronic Renal Insufficiency Cohort (CRIC) study evaluated data on 3791 participants. This data included baseline estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR), as well as crude rates and rate ratios of HF hospitalizations and 30-day HF rehospitalizations.


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The overall crude rate of HF admissions was 5.8 per 100 person-years; participants with HF with preserved ejection fraction had a higher rate than those with HF with reduced ejection fraction.

Participants with a lower eGFR (≤ 44 ml/min/1.73 m2) had higher adjusted rates of HF, and participants with a higher urine ACR (≥ 30 mg/g) had significantly higher adjusted rates of HF hospitalization.

Among all the participants, 20.6% had a subsequent HF re-admission within 30 days. 

“HF hospitalization within 2 years of study entry was associated with greater adjusted risks for CKD progression (1 hospitalization: hazard ratio [HR]: 1.93; 95% confidence interval [CI]: 1.40 to 2.67; 2+ hospitalizations: HR: 2.14; 95% CI: 1.30 to 3.54) and all-cause death (1 hospitalization: HR: 2.20; 95% CI: 1.71 to 2.84; 2+ hospitalizations: HR: 3.06; 95% CI: 2.23 to 4.18),” the researchers wrote.

“HF prevention and treatment should be a public health priority to improve CKD outcomes,” the researchers concluded.

—Colleen Murphy

Reference:

Bansal N, Zelnick L, Bhat Z, et al. Burden and outcomes of heart failure hospitalizations in adults with chronic kidney disease. J Am Coll Cardiol. 2019;73(21)2691-2700. doi:10.1016/j.jacc.2019.02.071.