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Bilchick KC, Chishinga N, Parker AM, et al. Plasma Volume and Renal Function Predict Six-Month Survival after Hospitalization for Acute Decompensated Heart Failure. Cardiorenal Med. 2017;8(1):61-70doi: 10.1159/000481149.
Bilchick, K. C., Chishinga, N., Parker, A. M., Zhuo, D. X., Rosner, M. H., Smith, L. A., Mwansa, H., Blackwell, J. N., McCullough, P. A., & Mazimba, S. (2017). Plasma Volume and Renal Function Predict Six-Month Survival after Hospitalization for Acute Decompensated Heart Failure. Cardiorenal medicine, 8(1), 61-70. https://doi.org/10.1159/000481149
Bilchick, Kenneth C, et al. "Plasma Volume and Renal Function Predict Six-Month Survival after Hospitalization for Acute Decompensated Heart Failure." Cardiorenal medicine vol. 8,1 (2017): 61-70. doi: https://doi.org/10.1159/000481149
Bilchick KC, Chishinga N, Parker AM, Zhuo DX, Rosner MH, Smith LA, Mwansa H, Blackwell JN, McCullough PA, Mazimba S. Plasma Volume and Renal Function Predict Six-Month Survival after Hospitalization for Acute Decompensated Heart Failure. Cardiorenal Med. 2017 Dec;8(1):61-70. doi: 10.1159/000481149. Epub 2017 Nov 03. PMID: 29344027; PMCID: PMC5757574.
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Cardiorenal Med. 2017 Dec;8(1):61-70. doi: 10.1159/000481149. Epub 2017 Nov 03.

Plasma Volume and Renal Function Predict Six-Month Survival after Hospitalization for Acute Decompensated Heart Failure.

Cardiorenal medicine

Kenneth C Bilchick, Nathaniel Chishinga, Alex M Parker, David X Zhuo, Mitchell H Rosner, LaVone A Smith, Hunter Mwansa, Jacob N Blackwell, Peter A McCullough, Sula Mazimba

Affiliations

  1. Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, Virginia, USA.
  2. Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA.
  3. St Vincent Charity Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
  4. Baylor University Medical Center, Dallas, Texas, USA.

PMID: 29344027 PMCID: PMC5757574 DOI: 10.1159/000481149

Abstract

BACKGROUND: Plasma volume (PV) is contracted in stable patients with heart failure (HF) due to decongestion strategies. On the other hand, increased PV can adversely affect the trajectory of HF. We therefore examined the effects of increased percentage change in PV (%ΔPV), blood urea nitrogen (BUN), and %ΔPV stratified by BUN and glomerular filtration rate (GFR) on survival after discharge in patients hospitalized for acute decompensated HF (ADHF).

METHODS: We used the Strauss-Davis-Rosenbaum formula to calculate the %ΔPV between baseline and hospital discharge in a cohort from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial (ESCAPE). Kaplan-Meier curves were constructed for survival over 6 months. Cox proportional hazards regression was used to obtain adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations between survival after discharge and %ΔPV, BUN, and %ΔPV stratified by BUN and GFR.

RESULTS: Of the 324 patients included in our study (age 56.1 ± 13.6 years, 26.5% female), those with increased or no %ΔPV at discharge were less likely to survive at 6 months compared with those having reduced %ΔPV (log rank,

CONCLUSIONS: Increased %ΔPV and BUN at discharge predicted worse 6-month survival in patients with ADHF. Decreased %ΔPV with low BUN or high GFR at discharge was associated with improved survival.

Keywords: Heart failure; Mortality; Plasma volume

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