心不全患者における慢性腎臓病の合併と生命予後に関する検討

概要

論文の詳細を見る
Background: Chronic kidney disease (CKD) has been shown to be an independent risk factor for heart failure patients in some reports from western countries. But it is not clear whether a similar association exists in Japanese patients. Methods and Results: We analyzed data from a retrospective cohort of consecutive 652 patients with heart failure who had serum creatinine measured at baseline. Mean age was 61 years, and 29% was ischemic heart disease. By the abbreviated modification of diet in renal disease study (MDRD) equation, 51 patients (7.8%) had glomerular filtration rate (GFR) 30 ml/min/1.73m^2 or less (severe renal insufficiency [RI]), 457 (70.1%) had GFR between 30 and 59 ml/min/1.73m^2 (moderate RI) and 144 (22.1%) had GFR 60 ml/min/1.73m^2 and up (no CKD). During follow-up (mean 3.5 years), 150 patients (23%) died. The 3 years death rates among individuals with severe RI, moderate RI and without CKD were 41.2% (hazard ratio [HR] 3.18, 95% confidence interval [CI] 1.72 to 5.88), 23.9% (HR 1.67, 95%CI 1.04 to 2.70) and 13.9% respectively. Conclusions: Chronic kidney disease is more prevalent in patients with heart failure than previously reported and is an prognostic factor in heart failure patients in Japan.
東京女子医科大学の論文