Clinical implications of the blood urea nitrogen/creatinine ratio in heart failure and their association with haemoconcentration
In: ESC Heart Failure ESC Heart Failure, Jg. 6 (2019), Heft 6, S. 1274-1282
Online
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Zugriff:
Aims The blood urea nitrogen (BUN)/creatinine ratio is a strong prognostic indicator in patients with acute decompensated heart failure (ADHF). However, the clinical impact of a high BUN/creatinine ratio at discharge with respect to renal dysfunction, neurohormonal hyperactivity, and different responsiveness to decongestion therapy remains unclear. Herein, we examined (i) the predictive value of a high BUN/creatinine ratio at discharge and (ii) its haemoconcentration‐dependent effects, in patients with ADHF. Methods and results The West Tokyo Heart Failure registry was a multicentre, prospective cohort registry‐based study that enrolled patients hospitalized with a diagnosis of ADHF. The endpoint was post‐discharge all‐cause death. Based on the degree of haemoconcentration, patients (n = 2090) were divided into four subcategories. In multivariate proportional hazard analyses, a higher BUN/creatinine ratio was independently associated with higher all‐cause mortality in the total population and in the extreme haemodilution (ΔHaemoglobin ≤ −0.9 g/dL) and haemoconcentration (0.8 g/dL ≤ ΔHaemoglobin) subcategories, but not in the modest haemodilution/haemoconcentration subcategories. Conclusions A higher BUN/creatinine ratio at discharge was independently associated with higher post‐discharge all‐cause mortality in patients with ADHF. The predictive value of a high BUN/creatinine ratio at discharge was haemoconcentration dependent and may be an unfavourable predictor in patients showing excessive haemoconcentration and haemodilution, but not in those showing modest haemoconcentration/haemodilution.
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Clinical implications of the blood urea nitrogen/creatinine ratio in heart failure and their association with haemoconcentration
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Autor/in / Beteiligte Person: | Shiraishi, Yasuyuki ; Nishimura, Shigeyuki ; Kohno, Takashi ; Nagatomo, Yuji ; Goda, Ayumi ; Tanno, Jun ; Muramatsu, Toshihiro ; Nakano, Shintaro ; Mizuno, Atsushi ; Yoshikawa, Tsutomu ; Kohsaka, Shun ; Sujino, Yasumori |
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Zeitschrift: | ESC Heart Failure ESC Heart Failure, Jg. 6 (2019), Heft 6, S. 1274-1282 |
Veröffentlichung: | Wiley, 2019 |
Medientyp: | unknown |
ISSN: | 2055-5822 (print) |
DOI: | 10.1002/ehf2.12531 |
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