Burden and Outcomes of Heart Failure Hospitalizations in Adults With Chronic Kidney Disease

Data on rates of heart failure (HF) hospitalizations, recurrent hospitalizations, and outcomes related to HF hospitalizations in chronic kidney disease (CKD) are limited. This study examined rates of HF hospitalizations and re-hospitalizations within a large CKD population and evaluated the burden o...

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Published in:	Journal of the American College of Cardiology 2019-06, Vol.73 (21), p.2691-2700
Main Authors:	Bansal, Nisha, Zelnick, Leila, Bhat, Zeenat, Dobre, Mirela, He, Jiang, Lash, James, Jaar, Bernard, Mehta, Rupal, Raj, Dominic, Rincon-Choles, Hernan, Saunders, Milda, Schrauben, Sarah, Weir, Matthew, Wright, Julie, Go, Alan S., Appel, Lawrence J., Feldman, Harold I., Lash, James P., Rao, Panduranga S., Rahman, Mahboob, Townsend, Raymond R.
Format:	Article
Language:	eng
Subjects:	Aged chronic kidney disease Confidence intervals Creatinine Death Disease control Disease Progression end-stage renal-disease Epidermal growth factor receptors Family medical history Female Glomerular Filtration Rate Health care policy Heart diseases Heart Failure Hemodialysis Hospitalization Hospitalization - statistics & numerical data Humans Kidney diseases Kidneys Laboratories Male Medical records Middle Aged Mortality outcomes Patient Readmission - statistics & numerical data Patients Poisson density functions Prospective Studies Public health Regression analysis Regression models Renal insufficiency Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - mortality Statistical analysis Studies Transplants & implants Ultrasonic imaging United States - epidemiology Urine
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Summary:	Data on rates of heart failure (HF) hospitalizations, recurrent hospitalizations, and outcomes related to HF hospitalizations in chronic kidney disease (CKD) are limited. This study examined rates of HF hospitalizations and re-hospitalizations within a large CKD population and evaluated the burden of HF hospitalizations with the risk of subsequent CKD progression and death. The prospective CRIC (Chronic Renal Insufficiency Cohort) study measured the estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR) at baseline. The crude rates and rate ratios of HF hospitalizations and 30-day HF re-hospitalizations were calculated using Poisson regression models. Cox regression was used to assess the association of the frequency of HF hospitalizations within the first 2 years of follow-up with risk of subsequent CKD progression and death. Among 3,791 participants, the crude rate of HF admissions was 5.8 per 100 person-years (with higher rates of HF with preserved ejection fraction vs. HF with reduced ejection fraction). The adjusted rate of HF was higher with a lower eGFR (vs. eGFR >45 ml/min/1.73 m2); the rate ratios were 1.7 and 2.2 for eGFR 30 to 44 and 45 ml/min/1.73 m2), respectively. Similarly, the adjusted rates of HF hospitalization were significantly higher in those with higher urine ACR (vs. urine ACR
ISSN:	0735-1097 1558-3597