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Title: Prognostic value of glomerular filtration rate estimation equations in acute heart failure with preserved versus reduced ejection fraction
Authors: Casado Cerrada, J.
Carrasco Sánchez, F. J.
Pérez-Calvo, J. I.
Manzano, L.
Formiga, F.
Aramburu Bodas, O.
Conde, A. 
Quirõs, R.
Pérez Bocanegra, C.
Montero-Pérez-Barquero, M.
UNESCO Clasification: 32 Ciencias médicas
3201 Ciencias clínicas
Keywords: Glomerular filtration
Acute heart failure
Renal function
Issue Date: 2015
Journal: International Journal of Clinical Practice 
Abstract: Aims Renal function is an important prognostic factor in heart failure. The aim of this study was to compare the predictive value of estimated renal function calculated by the Chronic Kidney Disease-Epidemiology Collaboration equation (CKD-EPI) and the abbreviated Modification of Diet in Renal Disease (MDRD-4) equation for long-term all-cause mortality in patients admitted for acute decompensated heart failure (ADHF) with both preserved ejection fraction (HF-PEF) and reduced ejection fraction (HF-REF). Methods and Results We evaluated patients included in the Spanish National Registry of Heart Failure (RICA). RICA is a multicentre, prospective, cohort study that included patients admitted to the Internal Medicine units with ADHF. Estimated glomerular filtration rate (eGFR) was calculated with CKD-EPI and MDRD-4 equations. A total of 1805 patients admitted for ADHF were studied (52% women; median age 80 years, interquartile range 73.9–84.6 years); of these, 1044 (58%) had HF-PEF. eGFR values were lower with the CKD-EPI formula than with the MDRD-4 formula (51 ml/min/1.73 m2 vs. 55.7 ml/min/1.73 m2; p < 0.001). The two formulas provided independent prognostic information over long-term follow-up, in both HF-PEF and HF-REF patients. However, in HF-PEF patients, CKD-EPI equation was associated with a significant improvement in reclassification analyses (net reclassification improvement 6.78%; p = 0.009). Conclusions In this clinical cohort of ADHF patients, eGFR as calculated by both the CKD-EPI and the MDRD-4 formulas offered similar prognostic information, irrespective of ejection fraction status, but in HF-PEF patients specifically, the CKD-EPI formula seems to improve clinical risk stratification as compared with MDRD-4.
ISSN: 1368-5031
DOI: 10.1111/ijcp.12616
Source: International Journal of Clinical Practice[ISSN 1368-5031],v. 69(8), p. 829-839 (julio 2015)
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