Premium
Baseline Albumin Is Associated with Worsening Renal Function in Patients with Acute Decompensated Heart Failure Receiving Continuous Infusion Loop Diuretics
Author(s) -
Clarke Megan M.,
Dorsch Michael P.,
Kim Susie,
Aaronson Keith D.,
Koelling Todd M.,
Bleske Barry E.
Publication year - 2013
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1241
Subject(s) - medicine , acute decompensated heart failure , hazard ratio , confidence interval , heart failure , renal function , loop diuretic , cardiology , proportional hazards model , population , environmental health
Study Objectives To identify baseline predictors of worsening renal function ( WRF) in an acute decompensated heart failure ( ADHF ) patient population receiving continuous infusion loop diuretics. Design Retrospective observational analysis. Setting Academic tertiary medical center. Patients A total of 177 patients with ADHF receiving continuous infusion loop diuretics from January 2006 through June 2009. Measurements and Main Results The mean patient age was 61 years, 63% were male, ~45% were classified as New York Heart Association functional class III , and the median length of loop diuretic infusion was 4 days. Forty‐eight patients (27%) developed WRF , and 34 patients (19%) died during hospitalization. Cox regression time‐to‐event analysis was used to determine the time to WRF based on different demographic and clinical variables. Baseline serum albumin 3 g/dl or less was the only significant predictor of WRF (hazard ratio [HR] 2.87, 95% confidence interval [CI] 1.60–5.16, p=0.0004), which remained significant despite adjustments for other covariates. Conclusion Serum albumin 3 g/dl or less is a practical baseline characteristic associated with the development of WRF in patients with ADHF receiving continuous infusion loop diuretics.