ISSN 1016-5169 | E-ISSN 1308-4488
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The product of eGFR and hemoglobin may help predict mortality in systolic heart failure patients without severe anemia and renal failure [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2012; 40(1): 9-15 | DOI: 10.5543/tkda.2012.01496

The product of eGFR and hemoglobin may help predict mortality in systolic heart failure patients without severe anemia and renal failure

Mehmet Birhan Yılmaz, Ali Zorlu, Gökhan Bektaşoğlu, Osman Can Yontar, İzzet Tandoğan
Department of Cardiology, Cumhuriyet University Faculty Of Medicine, Sivas


OBJECTIVES
Cardiorenal anemia syndrome is defined in patients with heart failure (HF). Although individual influences of renal impairment and anemia were shown previously, complex interaction between the kidney, bone marrow, and the heart renders decision making relatively inefficient in patients with milder forms of these diseases. We aimed to investigate whether product of estimated glomerular filtration rate (eGFR) and hemoglobin (Hb) predicts outcomes in patients with HF.

STUDY DESIGN
The study included 148 consecutive patients (89 males, 59 females; mean age 68±10 years) who were hospitalized with acutely decompensated systolic HF and discharged alive. Discharge Hb levels were measured. Renal function was estimated via the MDRD (Modification of Diet in Renal Disease) formula. The eGFRxHb product was derived, and cut-off was defined using the ROC (receiver operating characteristic) analysis. The influence of eGFRxHb product on mortality was analyzed after a follow- up period of up to 34 months (mean 8.2±5.5 months).

RESULTS
The mean Hb was 12.7±2 g/dl, the mean creatinine was 105±46 μmol/l, and the mean eGFR was 61±23 ml/min/1.73 m2. Eighty-two patients (55.4%) had an eGFR of <60 ml/kg/m2. During the follow-up, 27 patients died. Optimal cut-off level of eGFRxHb product to predict mortality was found to be ≤788 with a sensitivity of 82.6% and specificity of 51.3%. In multivariate Cox proportional analysis, only eGFRxHb product ≤788 (HR 4.488, 95% CI 1.500-13.433, p=0.007) and presence of atrial fibrillation (HR 2.644, 95% CI 1.113-6.280, p=0.028) were independent predictors of mortality in patients with HF.

CONCLUSION
We concluded that the product of eGFR and Hb might be useful in prediction of mortality among patients with systolic HF.

Keywords: Anemia, glomerular filtration rate, heart failure, systolic/ mortality; kidney diseases/complications; risk factors

Corresponding Author: Mehmet Birhan Yılmaz, Türkiye
Manuscript Language: English
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