The impact of the first 24 h of loop diuretic on kidney function in acute decompensated heart failure

2020 ◽  
Author(s):  
Mohannad Alshibani ◽  
Samah Alshehri ◽  
Ahmad Bakhaider ◽  
Abdulelah Atbani ◽  
Mahamad Ismail ◽  
...  
Keyword(s):  
Heart Failure ◽  
Kidney Function ◽  
Loop Diuretic ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
The Impact

scholarly journals ALTERATION IN RENAL FUNCTION FOLLOWING LOOP DIURETICS IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

2019 ◽  
pp. 61-63
Author(s):  
PRUDENCE A RODRIGUES ◽  
SOUMYA GK ◽  
NADIA GRACE BUNSHAW ◽  
SARANYA N ◽  
SUJITH K ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Renal Injury ◽  
Loop Diuretic ◽  
Acute Decompensated Heart Failure ◽  
Diuretic Therapy ◽  
Decompensated Heart Failure ◽  
Loop Diuretics ◽  
Contributing Factors ◽  
The Impact

Objective: The objective of the study was to monitor the impact of loop diuretic therapy in patients with acute decompensated heart failure (ADHF) and to assess other predictors of renal dysfunction in patients with ADHF. Methods: An observational study over a period of 6 months from January 2018 to June 2018 in the Department of Cardiology, in a Tertiary Care Teaching Hospital, Coimbatore, Tamil Nadu. Patients on diuretic therapy (loop diuretic) were enrolled. Patients with prior chronic kidney disease were excluded from the study. The patients were evaluated based on change in serum creatinine (SCr) and other contributing factors were assessed by acute kidney injury network and worsening of renal function criteria. Results: A total of 135 patients were enrolled, of which 73% were males and 27% were females. The mean age of the subjects was 61.55±13 years. The baseline means SCr was 1.62±0.92 mg/dl. On evaluation, 41% were really affected and 59% remain unaffected. Factors such as hypertension (p=0.047) and angiotensin-converting enzyme inhibitors (ACE-I) (p=0.023) were found to be significant predictors of renal injury. Conclusion: Variation in renal function in ADHF patients was multifactorial. The direct influence of loop diuretics on renal function was present but was not well established. Hypertension and ACE-I have found to show influence in the development of renal injury as contributing factors. There exists both positive and negative consequence of loop diuretics on renal function.

scholarly journals The Impact of Early Tolvaptan Administration in the Patients Admitted by Acute Decompensated Heart Failure

2016 ◽  
Vol 22 (9) ◽  
pp. S187
Author(s):  
Kei Tsukamoto ◽  
Kenjiro Oyabu ◽  
Kazuyuki Hamada ◽  
Syun Hasegawa ◽  
Masahiro Watanabe ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
The Impact

scholarly journals The impact of ultrafiltration in acute decompensated heart failure: A systematic review and meta-analysis

2014 ◽  
Vol 2 ◽  
pp. 19-25 ◽  
Author(s):  
Nader Makki ◽  
Seth Maliske ◽  
Amy Blevins ◽  
Saket Girotra ◽  
Peter Cram
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Acute Decompensated Heart Failure ◽  
Meta Analysis ◽  
Decompensated Heart Failure ◽  
The Impact

Observation of Patients Transitioned to an Oral Loop Diuretic Before Discharge and Risk of Readmission for Acute Decompensated Heart Failure

2017 ◽  
Vol 23 (10) ◽  
pp. 746-752 ◽  
Author(s):  
Benjamin Laliberte ◽  
Brent N. Reed ◽  
Sandeep Devabhakthuni ◽  
Kristin Watson ◽  
Vijay Ivaturi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Loop Diuretic ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure

scholarly journals Renal Function during Hospitalization and Outcome in Chinese Patients with Acute Decompensated Heart Failure

2021 ◽  
Author(s):  
Hao-Wei Lee ◽  
Chin-Chou Huang ◽  
Chih-Yu Yang ◽  
Hsin-Bang Leu ◽  
Po-Hsun Huang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Clinical Outcomes ◽  
Acute Decompensated Heart Failure ◽  
Significant Risk ◽  
Decompensated Heart Failure ◽  
Chinese Patients ◽  
Cox Regression Analysis ◽  
The Impact

Abstract It is well known that the heart and kidney have a bi-directional correlation, in which organ dysfunction results in maladaptive changes in the other. We aimed to investigate the impact of renal function and its decline during hospitalization on clinical outcomes in patients with acute decompensated heart failure (ADHF). A total of 119 consecutive Chinese patients admitted for ADHF were prospectively enrolled. The course of renal function was presented with estimated glomerular filtration rate (eGFR), calculated by the four-variable equation proposed by the Modification of Diet in Renal Disease (MDRD) Study. Worsening renal function (WRF), defined as eGFR decline between admission (eGFRadmission) and pre-discharge (eGFRpredischarge), occurred in 41 patients. Clinical outcomes during the follow-up period were defined as 4P-major adverse cardiovascular events (4P-MACE), including the composition of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and nonfatal HF hospitalization. During an average follow-up period of 2.6±3.2 years, 66 patients experienced 4P-MACE. Cox regression analysis revealed that impaired eGFRpredischarge, but not eGFRadmission or WRF, was significantly correlated with the development of 4P-MACE (HR, 2.003; 95% CI, 1.072–3.744; P=0.029). In conclusion, impaired renal function before discharge, but not WRF, is a significant risk factor for poor outcomes in patients with ADHF.

scholarly journals The Impact of Discharged Loop Diuretic Dose to Home Dose on Hospital Readmissions in Patients with Acute Decompensated Heart Failure: A Retrospective Cohort Study

2020 ◽  
Vol 23 (4) ◽  
pp. E470-E474 ◽  
Author(s):  
Mohannad Alshibani ◽  
Samah Alshehri ◽  
Wejdan Alyazidi ◽  
Asmaa Alnomani ◽  
Ziyad Almatruk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Retrospective Cohort ◽  
Readmission Rate ◽  
Dose Group ◽  
Loop Diuretic ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Readmission Rates ◽  
Daily Discharge

Background: Acute decompensated heart failure (ADHF) is associated with a high rate of hospital readmission. The aim of this study is to examine the effect of the discharge diuretic dose compared with the home diuretic dose on hospital readmission in patients with ADHF. Methods: A single center retrospective cohort study included patients with a confirmed diagnosis of ADHF with an ejection fraction of less than 40%. The sample was divided in two groups. The first group received a total daily discharge diuretic dose that was greater than the home dose; the second group received a daily discharge diuretic that was equal to or less than the home dose. The primary outcome was all-cause 30-day readmission rate. The secondary outcomes were all-cause 60-day and 90-day readmission rates. Results: A total of 206 patients met inclusion criteria; 117 patients received a higher loop diuretic dose at discharge, while 89 were discharged with a loop diuretic that was equal to or less than the home dose. Patients in the increased-dose group had an all-cause 30-day readmission rate of 20.5% compared with 37.1% of patients with equal or reduced-dose group; P = .007. Additionally, there were lower readmission rates in 60 and 90 days between the increased and equal or reduced groups (33.3% versus 52.8%, P < .017, and 41.0% versus 62.9%, P < .003, respectively. Conclusions: Among patients admitted to hospital with ADHF and reduced ejection fraction, a discharge loop diuretic dose higher than the home dose was associated with decreased all-cause 30-day, 60-day, and 90-day readmission rates.

Impact of Potentially Unwarranted Intravenous Antibiotics Targeting Pulmonary Infections in Acute Decompensated Heart Failure

2021 ◽  
pp. 875512252110380
Author(s):  
Sara Wu ◽  
Maryam Alikhil ◽  
Rochelle Forsyth ◽  
Bryan Allen
Keyword(s):  
Heart Failure ◽  
Primary Outcome ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Hospital Length ◽  
Loop Diuretics ◽  
Hospital Length Of Stay ◽  
Pulmonary Infections ◽  
Intravenous Antibiotics ◽  
The Impact

Background Acute decompensated heart failure (ADHF) can present similarly to pulmonary infections. The additional volume and sodium received from intravenous antibiotics (IVAB) can be counterproductive, especially when strong evidence of infection is lacking. Objective The objective was to evaluate the impact of potentially unwarranted IVAB on clinical outcomes in patients with ADHF. Methods This multicenter, retrospective, cohort study evaluated adults admitted with ADHF, a chest radiograph within 24 hours, B-natriuretic peptide >100 pg/mL, and either received no IVAB or IVAB for at least 48 hours. Subjects with recent antibiotics, justification for antibiotics, or transferred to the intensive care unit (ICU) within 24 hours of admission were excluded. The primary outcome was hospital length of stay (LOS). Secondary outcomes included utilization of loop diuretics, administration of fluid and sodium, mortality, and 30-day readmissions. Results Out of 240 subjects included, 120 received IVAB. LOS was significantly longer in the IVAB group (5.12 days vs 3.73 days; P < .001). LOS remained significantly longer in the IVAB group in a propensity score matched cohort (5.26 days vs 3.70 days; P < .001). The IVAB group received more volume and sodium from intravenous fluids ( P < .001). ICU admission greater than 24 hours after admission was higher with IVAB (20% vs 7.5%; P = .049). No significant differences in total loop diuretics, intubation rate, mortality, and 30-day readmissions were identified. Conclusion ADHF patients who received potentially unwarranted IVAB had longer hospital LOS and were more likely to be admitted to the ICU after 24 hours of hospitalization.

scholarly journals Association between Severity of Anemia and 30-Day Readmission Rate: Archival Data of 847 Patients with Acute Decompensated Heart Failure

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Jorge C. Busse ◽  
Tanya M. Cohn ◽  
Rosalina Butao ◽  
Julie Lamoureux
Keyword(s):  
Heart Failure ◽  
Readmission Rate ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
High Rate ◽  
Archival Data ◽  
Readmission Rates ◽  
Low Sodium ◽  
Related Group ◽  
The Impact

Hospitals today are facing adjustments to reimbursements from excessive readmission rates. One of the most common and expensive causes of readmissions is exacerbation of a heart failure condition. The objective of this paper was to determine if there was an association between the presence of anemia in patients with acute decompensated heart failure and their readmission rate. Using archival data of 4 hospitals in the Miami area, a sample of 847 inpatients with a diagnostic related group (DRG) of HF at discharge was considered. There was a significant association between low hemoglobin values and a high rate of readmissions at 14 days and at 30 days in subjects with normal sodium and creatinine values. For subjects with low sodium and high creatinine values, a higher readmission rate was seen in men with low hemoglobin but not in women. These results support a prospective effort to measure the impact of anemia and its treatment on readmission rates.

Sign in / Sign up

Export Citation Format

Share Document