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Prognostic significance of worsening blood urea nitrogen in patients with acute heart failure

Session Poster Session 3

Speaker Pakin Lalitnithi

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : P Lalitnithi (Bangkok,TH), P Sriparn (Bangkok,TH), M Anuntasainont (Bangkok,TH), C Thimphitthaya (Bangkok,TH), S Kittiprachakul (Bangkok,TH), A Trongtorsak (Bangkok,TH), A Ariyachaipanich (Bangkok,TH)

P Lalitnithi1 , P Sriparn1 , M Anuntasainont1 , C Thimphitthaya1 , S Kittiprachakul1 , A Trongtorsak1 , A Ariyachaipanich1 , 1King Chulalongkorn Memorial Hospital, Department of Internal Medicine - Bangkok - Thailand ,


Background: Apart from worsening creatinine (Cr) during hospitalisation with acute heart failure (AHF), Blood urea nitrogen (BUN) is another predictive value of renal impairment which represents the cumulative effect of both kidney function and arterial intravascular volume, including renal perfusion. However, the effect of worsening BUN (WBUN) during hospitalisation on long-term clinical outcome is still less well-established.

Purpose: The aim of this study was to determine the effect of WBUN on 180-day day all-cause mortality after discharge in patient with AHF

Methods: This was a retrospective cohort of consecutive patients who were diagnosed with acute HF and discharged from an academic tertiary care hospital from July 2017 to March 2018. WBUN was defined by increasing of BUN = 25% from admission value. The 180-day all-cause mortality after discharge was assessed using chi-square, univariate and survival analysis.

Results: Of the 191 patients (52.9% male, mean age 68.5 ±13 years and 35% with left ventricular ejection fraction= 40%), the average admission BUN and serum Cr were 31.5 mg/dL and 1.8 mg/dL, respectively. WBUN occurred in 107 patients (56%). The 180-day all-cause mortality rate was higher in WBUN group compared with no WBUN group (19.6% versus 8.5%, p < 0.05). However, worsening renal function (WRF), defined by increased Cr = 0.3 mg/dL or = 25%, was not associated with worse outcome (18.5% versus 12.5%, p > 0.05).

Conclusion: More than half of patients admitted for AHF have WBUN during hospitalisation. This study demonstrates that WBUN, but not WRF, is a prognostic marker on long-term outcome after hospitalised with AHF.

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