Any heart failure treatments associated with worsening renal function in patients admitted due to acute heart failure?

Figures & data

Table 1. Baseline characteristics of patients admitted with heart failure categorized by presence of worsening renal function (WRF) during hospitalization (n = 301).

Factors	No WRF n = 219	WRF n = 82	p Value
Mean (SD) age, year	66.47 (15.69)	67.57 (13.46)	.675
Male sex, n (%)	94 (42.92)	27 (32.93)	.146
Mean (SD) Body mass index, kg/m^2	26.54 (7.15)	27.25 (8.28)	.774
Comorbid diseases, n (%)
Hypertension	159 (72.60)	69 (84.15)	.049
Diabetes	121 (55.25)	50 (60.98)	.433
Coronary artery disease	55 (25.11)	23 (28.05)	.658
Atrial fibrillation	28 (12.79)	12 (14.63)	.704
Dyslipidemia	118 (53.88)	48 (58.54)	.516
Stroke/TIA	16 (7.31)	5 (6.10)	.805
Chronic kidney disease	166 (75.80)	64 (78.05)	.761
Stage I	31 (14.16)	8 (9.76)	.174
Stage II	47 (21.46)	13 (15.85)
Stage III	58 (26.48)	23 (28.05)
Stage IV	36 (16.44)	15 (18.29)
Stage V, no dialysis	9 (4.11)	10 (12.20)
Unknown	38 (17.35)	13 (15.85)
NYHA FC, n (%)			.222
FC I	3 (1.37)	1 (1.22)
FC II	8 (3.65)	4 (4.88)
FC III	105 (47.95)	29 (35.37)
FC IV	103 (47.03)	48 (58.54)
Causes of heart failure, n (%)
Acute coronary syndrome	38 (17.35)	21 (25.61)	.141
Hypertensive emergency	24 (10.96)	11 (13.41)	.549
Cardiomyopathy	78 (35.62)	30 (36.59)	.893
Cardiac arrhythmia	34 (15.53)	6 (7.32)	.085

NYHA: New York Heart Association; FC: Functional Classification.

Table 2. Physical signs, laboratory results, and treatments in patients admitted with heart failure categorized by presence of worsening renal function (WRF) during hospitalization (n = 301).

Factors	No WRF n = 219	WRF n = 82	p Value
Systolic blood pressure, mmHg	150 (34)	156 (39)	.300
Diastolic blood pressure, mmHg	82 (22)	85 (22)	.169
Heart rate, bpm	82 (25)	90 (23)	.437
Oxygen saturation, %	91 (9)	89 (10)	.080
Hemoglobin, g/%	11.3 (2.5)	11.1 (2.3)	.436
Serum Cr, mg/dL	1.58 (1.36)	1.79 (1.34)	.050
Serum sodium, mEq/L	136 (5)	136 (5)	.746
BNP, pg/mL	9212 (10160)	17646 (26402)	.037
Ejection fraction, %	47 (17)	47 (18)	.739
Ejection fraction ≤40, n (%)	80 (36.53)	36 (43.90)	.287
Net balance/day, ml	−948.45 (1262.15)	−442.49 (973.12)	<.001
Intravenous furosemide, mg	183 (472)	397 (1117)	.078
Oral furosemide, mg	76 (183)	68 (169)	.563
Total dose of furosemide, mg	259 (561)	465 (1144)	.436
Intravenous inotropic agent, n (%)	18 (8.22)	13 (15.85)	.058
Intravenous nitroglycerin, n (%)	33 (15.07)	13 (15.85)	.859
Thiazide use, n (%)	4 (1.83)	0	.578
Dose, mg	34.37 (11.96)	0	NA
Spironolactone, n (%)	12 (5.48)	3 (3.66)	.767
Dose, mg	71.67 (77.10)	91.66 (94.64)	.884
ACEI/ARB, n (%)	89 (38.81)	28 (34.15)	.505
CCB, n (%)	69 (31.51)	23 (28.05)	.673
Betablocker, n (%)	137 (62.56)	39 (47.56)	.025
Nephrotoxic agent, n (%)
Contrast media	3 (1.37)	0	.565
Antibiotic	6 (2.74)	2 (2.44)	.999
NSAIDs	1 (0.46)	0	.999

Data presented as mean (SD) unless indicated otherwise; BNP: B-type natriuretic peptide; ACEI: angiotensin converting enzyme inhibitors; ARB: angiotensin receptor blocker; CCB: calcium channel blocker; NYHA: New York Heart Association; FC: Functional Classification; fluid therapy included both oral and intravenous forms.

Table 3. Factors associated with worsening renal function during hospitalization in patients admitted with heart failure.

Factors	Unadjusted odds ratio (95% confidence interval)	Adjusted odds ratio (95% confidence interval)
Diastolic blood pressure	1.007 (0.996, 1.018)	1.060 (1.008, 1.114)
Beta blocker treatment	0.542 (0.325, 0.906)	0.064 (0.006, 0.634)