Anemia and chronic kidney disease are associated with poor outcomes in heart failure patients

• Authors: Jean-Christophe Luthi, University of Lausanne; W Dana Flanders, Emory University; Michel Burnier, CHUV, Switzerland; Bernard Burnand, University of Lausanne; William McClellan, Emory University
• Journal Title: BMC Nephrology
• Volume: Volume 7, Number 3
• Publisher: BioMed Central | 2006
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/1471-2369-7-3
• Subjects: Health Sciences, Epidemiology; Health Sciences, General; Health Sciences, Health Care Management

Abstract

Background Chronic kidney disease (CKD) has been linked to higher heart failure (HF) risk. Anemia is a common consequence of CKD, and recent evidence suggests that anemia is a risk factor for HF. The purpose of this study was to examine among patients with HF, the association between CKD, anemia and inhospital mortality and early readmission.Methods We performed a retrospective cohort study in two Swiss university hospitals. Subjects were selected based the presence of ICD-10 HF codes in 1999. We recorded demographic characteristics and risk factors for HF. CKD was defined as a serum creatinine ≥ 124 956;mol/L for women and ≥ 133 μmol/L for men. The main outcome measures were inhospital mortality and thirty-day readmissions. Results Among 955 eligible patients hospitalized with heart failure, 23.0% had CKD. Twenty percent and 6.1% of individuals with and without CKD, respectively, died at the hospital (p < 0.0001). Overall, after adjustment for other patient factors, creatinine and hemoglobin were associated with an increased risk of death at the hospital, and hemoglobin was related to early readmission. Conclusion Both CKD and anemia are frequent among older patients with heart failure and are predictors of adverse outcomes, independent of other known risk factors for heart failure.