Chronic kidney disease as an independent risk for long-term adverse outcomes in patients hospitalized with heart failure in Japan - Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)

Sanae Hamaguchi, Miyuki Tsuchihashi-Makaya, Shintaro Kinugawa, Takashi Yokota, Tomomi Ide, Akira Takeshita, Hiroyuki Tsutsui

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Abstract

Background: Previous studies have demonstrated that renal dysfunction is common in patients with heart failure (HF), but it is not known whether chronic kidney disease (CKD) is associated with increased risks of long-term adverse outcomes in unselected HF patients encountered in current routine clinical practice in Japan. Methods and Results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied a broad sample of patients hospitalized with worsening HF and their outcomes with an average of 2.4 years of follow-up. The study cohort (n=2,013) were classified into 3 groups by estimated glomerular filtration rate (eGFR): ≥60 (n=579), 30-59 (n=1,025), and <30ml·min-1·1.73 m-2 or patients with dialysis (n=409); 1,372 patients (70.3%) had an eGFR <60 ml·min-1·1.73 m-2 and 62 patients were treated with dialysis. The multivariable adjusted risk for all-cause death or rehospitalization increased with reduced eGFR; an adjusted hazard ratio (HR) 1.520 (95% confidence interval (CI) 1.186-1.949) for eGFR 30-59 ml·min-1·1.73 m-2 (P=0.001) and HR 2.566 (95%CI 1.885-3.492) for eGFR <30 ml·min-1·1.73 m-2 or patients with dialysis (P<0.001). Conclusions: CKD is common in HF and was independently associated with long-term adverse outcomes in a broad cohort of Japanese patients.

Original languageEnglish
Pages (from-to)1442-1447
Number of pages6
JournalCirculation Journal
Volume73
Issue number8
DOIs
Publication statusPublished - Aug 1 2009

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Cardiology
Chronic Renal Insufficiency
Registries
Japan
Heart Failure
Glomerular Filtration Rate
Dialysis
Confidence Intervals
Cause of Death
Cohort Studies
Kidney

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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Chronic kidney disease as an independent risk for long-term adverse outcomes in patients hospitalized with heart failure in Japan - Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). / Hamaguchi, Sanae; Tsuchihashi-Makaya, Miyuki; Kinugawa, Shintaro; Yokota, Takashi; Ide, Tomomi; Takeshita, Akira; Tsutsui, Hiroyuki.

In: Circulation Journal, Vol. 73, No. 8, 01.08.2009, p. 1442-1447.

Research output: Contribution to journalArticle

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abstract = "Background: Previous studies have demonstrated that renal dysfunction is common in patients with heart failure (HF), but it is not known whether chronic kidney disease (CKD) is associated with increased risks of long-term adverse outcomes in unselected HF patients encountered in current routine clinical practice in Japan. Methods and Results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied a broad sample of patients hospitalized with worsening HF and their outcomes with an average of 2.4 years of follow-up. The study cohort (n=2,013) were classified into 3 groups by estimated glomerular filtration rate (eGFR): ≥60 (n=579), 30-59 (n=1,025), and <30ml·min-1·1.73 m-2 or patients with dialysis (n=409); 1,372 patients (70.3{\%}) had an eGFR <60 ml·min-1·1.73 m-2 and 62 patients were treated with dialysis. The multivariable adjusted risk for all-cause death or rehospitalization increased with reduced eGFR; an adjusted hazard ratio (HR) 1.520 (95{\%} confidence interval (CI) 1.186-1.949) for eGFR 30-59 ml·min-1·1.73 m-2 (P=0.001) and HR 2.566 (95{\%}CI 1.885-3.492) for eGFR <30 ml·min-1·1.73 m-2 or patients with dialysis (P<0.001). Conclusions: CKD is common in HF and was independently associated with long-term adverse outcomes in a broad cohort of Japanese patients.",
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AU - Hamaguchi, Sanae

AU - Tsuchihashi-Makaya, Miyuki

AU - Kinugawa, Shintaro

AU - Yokota, Takashi

AU - Ide, Tomomi

AU - Takeshita, Akira

AU - Tsutsui, Hiroyuki

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N2 - Background: Previous studies have demonstrated that renal dysfunction is common in patients with heart failure (HF), but it is not known whether chronic kidney disease (CKD) is associated with increased risks of long-term adverse outcomes in unselected HF patients encountered in current routine clinical practice in Japan. Methods and Results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied a broad sample of patients hospitalized with worsening HF and their outcomes with an average of 2.4 years of follow-up. The study cohort (n=2,013) were classified into 3 groups by estimated glomerular filtration rate (eGFR): ≥60 (n=579), 30-59 (n=1,025), and <30ml·min-1·1.73 m-2 or patients with dialysis (n=409); 1,372 patients (70.3%) had an eGFR <60 ml·min-1·1.73 m-2 and 62 patients were treated with dialysis. The multivariable adjusted risk for all-cause death or rehospitalization increased with reduced eGFR; an adjusted hazard ratio (HR) 1.520 (95% confidence interval (CI) 1.186-1.949) for eGFR 30-59 ml·min-1·1.73 m-2 (P=0.001) and HR 2.566 (95%CI 1.885-3.492) for eGFR <30 ml·min-1·1.73 m-2 or patients with dialysis (P<0.001). Conclusions: CKD is common in HF and was independently associated with long-term adverse outcomes in a broad cohort of Japanese patients.

AB - Background: Previous studies have demonstrated that renal dysfunction is common in patients with heart failure (HF), but it is not known whether chronic kidney disease (CKD) is associated with increased risks of long-term adverse outcomes in unselected HF patients encountered in current routine clinical practice in Japan. Methods and Results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied a broad sample of patients hospitalized with worsening HF and their outcomes with an average of 2.4 years of follow-up. The study cohort (n=2,013) were classified into 3 groups by estimated glomerular filtration rate (eGFR): ≥60 (n=579), 30-59 (n=1,025), and <30ml·min-1·1.73 m-2 or patients with dialysis (n=409); 1,372 patients (70.3%) had an eGFR <60 ml·min-1·1.73 m-2 and 62 patients were treated with dialysis. The multivariable adjusted risk for all-cause death or rehospitalization increased with reduced eGFR; an adjusted hazard ratio (HR) 1.520 (95% confidence interval (CI) 1.186-1.949) for eGFR 30-59 ml·min-1·1.73 m-2 (P=0.001) and HR 2.566 (95%CI 1.885-3.492) for eGFR <30 ml·min-1·1.73 m-2 or patients with dialysis (P<0.001). Conclusions: CKD is common in HF and was independently associated with long-term adverse outcomes in a broad cohort of Japanese patients.

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