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document
Association of chronic kidney disease with outcomes in chronic heart failure : a propensity-matched study . BACKGROUND Chronic kidney disease ( CKD ) is associated with increased mortality in patients with heart failure ( HF ) . However , its association with hospitalization in HF patients has not been well studied . METHODS Of 7788 patients in the Digitalis Investigation Group trial , 3527 had CKD , defined by an estimated glomerular filtration rate ( GFR ) < 60 ml/min/1.73 m ( 2 ) body surface area ( BSA ) . Propensity scores for CKD were calculated using a multivariable logistic regression model and used to match 2399 pairs of patients with and without CKD . Matched Cox regression analyses were used to estimate association of CKD with outcomes . RESULTS All-cause hospitalization occurred in 1636 ( rate , 4233/10,000 person-years ) and 1587 ( rate , 3733/10,000 person-years ) patients respectively , with and without CKD ( matched hazard ratio [ HR ] for CKD , 1.18 , 95 % confidence interval [ CI ] , 1.08-1.29 ; P < 0.0001 ) . Matched HR for cardiovascular and HF hospitalization were respectively 1.17 ( 95 % CI , 1.06-1.28 , P = 0.002 ) and 1.28 ( 95 % CI , 1.13-1.45 , P < 0.0001 ) . Compared to GFR > or=60 ml/min/1.73 m ( 2 ) BSA , HR for all-cause hospitalization for GFR 45-59 and < 45 ml/min/1.73 m ( 2 ) BSA were respectively 1.04 ( 95 % CI , 0.94-1.16 ; P = 0.422 ) and 1.58 ( 95 % CI , 1.34-1.87 ; P < 0.0001 ) . Similarly , HR for all-cause death for GFR 45-59 and < 45 ml/min/1.73 m ( 2 ) BSA were respectively 1.03 ( 95 % CI , 0.90-1.18 ; P = 0.651 ) and 1.70 ( 95 % CI , 1.40-2.07 ; P < 0.0001 ) . Matched HR for death due to cardiovascular causes and progressive HF were respectively 1.24 ( 95 % CI , 1.09-1.40 ; P = 0.001 ) and 1.42 ( 95 % CI , 1.16-1.72 ; P = 0.001 ) . CONCLUSION CKD was associated with increased mortality and hospitalization in ambulatory patients with chronic HF , which increased progressively with worsening kidney function .
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Intervention_Physical
multivariable logistic regression model
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Intervention_Educational
Matched Cox regression analyses
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Outcome_Physical
chronic heart failure
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Outcome_Mortality
mortality
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Outcome_Other
All-cause hospitalization
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Outcome_Physical
Matched HR for cardiovascular and HF hospitalization
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Outcome_Physical
HR for all-cause hospitalization for GFR
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Outcome_Mortality
HR for all-cause death for GFR 45-59 and < 45 ml/min/1.73 m ( 2 ) BSA
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Outcome_Mortality
Matched HR for death due to cardiovascular causes and progressive HF
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Outcome_Mortality
mortality
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Outcome_Physical
kidney function .
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Participant_Condition
chronic kidney disease
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Participant_Condition
chronic heart failure
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Participant_Condition
heart failure
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Participant_Condition
HF
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Participant_Condition
HF
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Participant_Sample-size
7788
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Participant_Sample-size
3527
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Participant_Condition
CKD
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Participant_Condition
ambulatory
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Participant_Condition
chronic HF