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McCallum W, Tighiouart H, Testani JM, et al. Association of Volume Overload With Kidney Function Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction. Kidney Int Rep. 2020;5(10):1661-1669doi: 10.1016/j.ekir.2020.07.015.
McCallum, W., Tighiouart, H., Testani, J. M., Griffin, M., Konstam, M. A., Udelson, J. E., & Sarnak, M. J. (2020). Association of Volume Overload With Kidney Function Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction. Kidney international reports, 5(10), 1661-1669. https://doi.org/10.1016/j.ekir.2020.07.015
McCallum, Wendy, et al. "Association of Volume Overload With Kidney Function Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction." Kidney international reports vol. 5,10 (2020): 1661-1669. doi: https://doi.org/10.1016/j.ekir.2020.07.015
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Association of Volume Overload With Kidney Function Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction. Kidney Int Rep. 2020 Jul 23;5(10):1661-1669. doi: 10.1016/j.ekir.2020.07.015. eCollection 2020 Oct. PMID: 33102958; PMCID: PMC7569703.
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Kidney Int Rep. 2020 Jul 23;5(10):1661-1669. doi: 10.1016/j.ekir.2020.07.015. eCollection 2020 Oct.

Association of Volume Overload With Kidney Function Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction.

Kidney international reports

Wendy McCallum, Hocine Tighiouart, Jeffrey M Testani, Matthew Griffin, Marvin A Konstam, James E Udelson, Mark J Sarnak

Affiliations

  1. Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA.
  2. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.
  3. Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts, USA.
  4. Division of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  5. Division of Cardiology and the CardioVascular Center, Tufts Medical Center, Boston, Massachusetts, USA.

PMID: 33102958 PMCID: PMC7569703 DOI: 10.1016/j.ekir.2020.07.015

Abstract

INTRODUCTION: In patients with heart failure with reduced ejection fraction (HFrEF), volume overload is associated with mortality. Few studies that have examined the relation between volume and long-term kidney function outcomes in HFrEF.

METHODS: Using data from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) trial, we used multivariable Cox regression models to evaluate the association between volume overload as evaluated by B-type natriuretic peptide (BNP) and N-terminal pro B-type natriuretic peptide (NT-proBNP), and a clinical congestion score (scale of 0-12) composed of pedal edema, jugular venous distension, rales, and orthopnea with the occurrence of estimated glomerular filtration rate (eGFR) decline by >40%, and incident chronic kidney disease (CKD) stage ≥4 defined by eGFR of <30 ml/min per 1.73 m

RESULTS: Among 3718 patients (mean eGFR 59 ± 22 ml/min per 1.73 m

CONCLUSION: Volume overload, as indicated both by elevated natriuretic peptides and clinical signs and symptoms, is associated with increased risk for clinically important kidney function outcomes in HFrEF.

© 2020 International Society of Nephrology. Published by Elsevier Inc.

Keywords: cardiorenal syndrome; congestion; heart failure with reduced ejection fraction; natriuretic peptides; volume overload

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