Baseline albumin is associated with worsening renal function in patients with acute decompensated heart failure receiving continuous infusion loop diuretics

Pharmacotherapy. 2013 Jun;33(6):583-8. doi: 10.1002/phar.1241. Epub 2013 Apr 1.

Abstract

Study objectives: To identify baseline predictors of worsening renal function (WRF) in an acute decompensated heart failure (ADHF) patient population receiving continuous infusion loop diuretics.

Design: Retrospective observational analysis.

Setting: Academic tertiary medical center.

Patients: A total of 177 patients with ADHF receiving continuous infusion loop diuretics from January 2006 through June 2009.

Measurements and main results: The mean patient age was 61 years, 63% were male, ~45% were classified as New York Heart Association functional class III, and the median length of loop diuretic infusion was 4 days. Forty-eight patients (27%) developed WRF, and 34 patients (19%) died during hospitalization. Cox regression time-to-event analysis was used to determine the time to WRF based on different demographic and clinical variables. Baseline serum albumin 3 g/dl or less was the only significant predictor of WRF (hazard ratio [HR] 2.87, 95% confidence interval [CI] 1.60-5.16, p=0.0004), which remained significant despite adjustments for other covariates.

Conclusion: Serum albumin 3 g/dl or less is a practical baseline characteristic associated with the development of WRF in patients with ADHF receiving continuous infusion loop diuretics.

MeSH terms

  • Academic Medical Centers
  • Acute Disease
  • Aged
  • Diuretics / administration & dosage
  • Diuretics / therapeutic use*
  • Female
  • Heart Failure / complications*
  • Heart Failure / drug therapy
  • Heart Failure / physiopathology
  • Humans
  • Infusions, Intravenous
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Regression Analysis
  • Renal Insufficiency / etiology*
  • Renal Insufficiency / physiopathology
  • Retrospective Studies
  • Serum Albumin / metabolism*
  • Time Factors

Substances

  • Diuretics
  • Serum Albumin