The following is a summary of “Effect of severity and etiology of chronic kidney disease in patients with heart failure with mildly reduced ejection fraction,” published in the May 2024 issue of Cardiology by Schupp et al.

There is uncertainty on how chronic kidney disease (CKD) severity and causes affect outcomes in heart failure patients with mildly reduced ejection fraction (HFmrEF). 

Researchers conducted a retrospective study to determine the correlation between CKD severity, causes, and prognosis in patients with HFmrEF. 

They studied consecutive patients with HFmrEF admitted at one institution between 2016 and 2022. Examination of patients with different stages and causes of CKD relates to patient outcomes. The primary endpoint of this study was focusing on all-cause mortality within 30 months. 

The results showed that 2,155 patients with HFmrEF were studied, with a CKD prevalence of 31%. Even mild CKD (KDIGO stage 3a) increased 30-month all-cause mortality risk (HR=1.242; 95% CI 1.147-1.346; P=0.001). The long-term prognosis didn’t differ significantly between KDIGO stage 4 and 5 (HR=0.886; 95% CI 0.616-1.275; P=0.515). Patients with KDIGO stages 3b and 4 had the highest risk of HF-related rehospitalization (log-rank P≤0.015), while stage 5 had a lower risk compared to stage 4 (HR=0.440; 95% CI 0.228-0.849; P=0.014). The etiology of CKD didn’t affect mortality or HF-related rehospitalization risk.

Investigators concluded that even in patients with mildly reduced heart function, mild kidney disease is linked to a higher risk of death over 30 months. 

Source: link.springer.com/article/10.1007/s00392-024-02453-y