Tubular Damage and Worsening Renal Function in Chronic Heart Failure

Kevin Damman; Serge Masson; Hans L. Hillege; Adriaan A. Voors; Dirk J. van Veldhuisen; Patrick Rossignol; Gianni Proietti; Savino Barbuzzi; Gian Luigi Nicolosi; Luigi Tavazzi; Aldo P. Maggioni; Roberto Latini

doi:10.1016/j.jchf.2013.05.007

Tubular Damage and Worsening Renal Function in Chronic Heart Failure

Kevin Damman^*, Serge Masson, Hans L. Hillege, Adriaan A. Voors, Dirk J. van Veldhuisen, Patrick Rossignol, Gianni Proietti, Savino Barbuzzi, Gian Luigi Nicolosi, Luigi Tavazzi, Aldo P. Maggioni, Roberto Latini

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

56 Citations (Scopus)

Abstract

Objectives This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) in chronic heart failure (HF)

Background WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF.

Methods In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers (N-acetyl-beta-D-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF.

Results A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p <0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariableadjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p = 0.001).

Conclusions WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336) (J Am Coll Cardiol HF 2013; 1: 417-24) (C) 2013 by the American College of Cardiology Foundation

Original language	English
Pages (from-to)	417-424
Number of pages	8
Journal	JACC. Heart failure
Volume	1
Issue number	5
DOIs	https://doi.org/10.1016/j.jchf.2013.05.007
Publication status	Published - Oct-2013

Keywords

heart failure
renal insufficiency
tubular damage
worsening renal function

Access to Document

10.1016/j.jchf.2013.05.007

Cite this

@article{162641232eba49c599208239b7e5302f,

title = "Tubular Damage and Worsening Renal Function in Chronic Heart Failure",

abstract = "Objectives This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) in chronic heart failure (HF)Background WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF.Methods In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers (N-acetyl-beta-D-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF.Results A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p <0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariableadjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p = 0.001).Conclusions WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336) (J Am Coll Cardiol HF 2013; 1: 417-24) (C) 2013 by the American College of Cardiology Foundation",

keywords = "heart failure, renal insufficiency, tubular damage, worsening renal function",

author = "Kevin Damman and Serge Masson and Hillege, {Hans L.} and Voors, {Adriaan A.} and {van Veldhuisen}, {Dirk J.} and Patrick Rossignol and Gianni Proietti and Savino Barbuzzi and Nicolosi, {Gian Luigi} and Luigi Tavazzi and Maggioni, {Aldo P.} and Roberto Latini",

year = "2013",

month = oct,

doi = "10.1016/j.jchf.2013.05.007",

language = "English",

volume = "1",

pages = "417--424",

journal = "JACC. Heart failure",

issn = "2213-1779",

publisher = "ELSEVIER SCI LTD",

number = "5",

}

Tubular Damage and Worsening Renal Function in Chronic Heart Failure. / Damman, Kevin; Masson, Serge; Hillege, Hans L.; Voors, Adriaan A.; van Veldhuisen, Dirk J.; Rossignol, Patrick; Proietti, Gianni; Barbuzzi, Savino; Nicolosi, Gian Luigi; Tavazzi, Luigi; Maggioni, Aldo P.; Latini, Roberto.

In: JACC. Heart failure, Vol. 1, No. 5, 10.2013, p. 417-424.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Tubular Damage and Worsening Renal Function in Chronic Heart Failure

AU - Damman, Kevin

AU - Masson, Serge

AU - Hillege, Hans L.

AU - Voors, Adriaan A.

AU - van Veldhuisen, Dirk J.

AU - Rossignol, Patrick

AU - Proietti, Gianni

AU - Barbuzzi, Savino

AU - Nicolosi, Gian Luigi

AU - Tavazzi, Luigi

AU - Maggioni, Aldo P.

AU - Latini, Roberto

PY - 2013/10

Y1 - 2013/10

N2 - Objectives This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) in chronic heart failure (HF)Background WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF.Methods In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers (N-acetyl-beta-D-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF.Results A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p <0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariableadjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p = 0.001).Conclusions WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336) (J Am Coll Cardiol HF 2013; 1: 417-24) (C) 2013 by the American College of Cardiology Foundation

AB - Objectives This study sought to investigate the relationship between tubular damage and worsening renal function (WRF) in chronic heart failure (HF)Background WRF is associated with poor outcome in chronic HF. It is unclear whether urinary tubular markers may identify patients at risk for WRF.Methods In 2,011 patients with chronic HF, we evaluated the ability of urinary tubular markers (N-acetyl-beta-D-glucosaminidase (NAG), kidney injury molecule (KIM)-1, and neutrophil gelatinase-associated lipocalin (NGAL) to predict WRF. Finally, we assessed the prognostic importance of WRF.Results A total of 290 patients (14.4%) experienced WRF during follow-up, and WRF was a strong and independent predictor of all-cause mortality and HF hospitalizations (hazard ratio [HR]: 2.87; 95% CI: 2.40 to 3.43; p <0.001). Patients with WRF had lower baseline glomerular filtration rate and higher KIM-1, NAG, and NGAL levels. In a multivariableadjusted model, KIM-1 was the strongest independent predictor of WRF (HR: 1.23; 95% CI: 1.09 to 1.39 per log increase; p = 0.001).Conclusions WRF was associated with strongly impaired outcome in patients with chronic HF. Increased level of urinary KIM-1 was the strongest independent predictor of WRF and could therefore be used to identify patients at risk for WRF and poor clinical outcome. (GISSI-HF-Effects of n-3 PUFA and Rosuvastatin on Mortality-Morbidity of Patients With Symptomatic CHF; NCT00336336) (J Am Coll Cardiol HF 2013; 1: 417-24) (C) 2013 by the American College of Cardiology Foundation

KW - heart failure

KW - renal insufficiency

KW - tubular damage

KW - worsening renal function

U2 - 10.1016/j.jchf.2013.05.007

DO - 10.1016/j.jchf.2013.05.007

M3 - Article

VL - 1

SP - 417

EP - 424

JO - JACC. Heart failure

JF - JACC. Heart failure

SN - 2213-1779

IS - 5

ER -