Publication

Differential associations between renal function and "modifiable" risk factors in patients with chronic heart failure

Smilde, T. D. J., Damman, K., van der Harst, P., Navis, G., Westenbrink, B. D., Voors, A. A., Boomsma, F., van Veldhuisen, D. J. & Hillege, H. L., Feb-2009, In : Clinical Research in Cardiology. 98, 2, p. 121-129 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

Reduced glomerular filtration rate (GFR) is strongly associated with reduced survival in patients with chronic heart failure (CHF). Our aim was to determine different pathophysiologic markers that are associated with reduced renal function in CHF.

We studied 86 patients with CHF (58 +/- A 12 years, 78% male). GFR and renal blood flow (RBF) were determined by (125)I-Iothalamate and (131)I-Hippuran clearances. Filtration fraction (FF) was calculated. We determined haemoglobin levels, endothelial function, inflammatory status, plasma renin activity (PRA) and N-terminal pro brain natriuretic peptide (NT-proBNP). Urinay albumin excretion (UAE) was measured in 24 h urine. Mean GFR was 74 +/- A 28 ml/min/1.73 m(2). GFR was strongly related to RBF (r = 0.915, P <0.001), FF (r = 0.546, P <0.001), but only weakly to endothelial function and PRA. In multivariate analysis, RBF (r = 0.938, P <0.001), FF (r = 0.786, P <0.001) and haemoglobin levels (r = -0.520, P <0.001) were independently associated with GFR. UAE was mainly dependent on RBF (r = -0.401, P <0.001) and increased exponentially with decreasing RBF. RBF was mainly associated with NT-proBNP (r = -0.561, P <0.001) and PRA (r = -0.422, P <0.001).

Reduced GFR is mainly dependent of decreased RBF in patients with CHF. Endothelial function and neurohormonal activation showed only mild associations with GFR. NT-proBNP showed a strong relationship with RBF, and may be used as a marker of reduced renal perfusion.

Original languageEnglish
Pages (from-to)121-129
Number of pages9
JournalClinical Research in Cardiology
Volume98
Issue number2
Publication statusPublished - Feb-2009

    Keywords

  • chronic heart failure, renal function, microalbuminuria, renal blood flow, plasma renin activity, NT-proBNP, BRAIN NATRIURETIC PEPTIDE, LEFT-VENTRICULAR DYSFUNCTION, GLOMERULAR-FILTRATION RATE, CARDIOVASCULAR MORTALITY, ANGIOTENSIN-II, ACE-INHIBITION, ELDERLY-MEN, PLASMA-FLOW, BLOOD-FLOW, IMPAIRMENT

ID: 4851525