Worsening Renal Function and Hemoconcentration Linked to Improved Heart Failure Survival

A retrospective analysis of heart failure (HF) patients in the US found that concurrent hemoconcentration and worsening renal function (WRF) identified a group with significantly improved post discharge survival. The analysis included 3061 patients hospitalized with HF. Hemoconcentration was defined as an increase in both hemoglobin and hematocrit, and WRF as a decrease in estimated glomerular filtration rate (eGFR) greater than 20% from baseline to any point in the hospitalization. WRF in the absence of hemoconcentration was associated with significantly reduced survival (HR = 1.5) and hemoconcentration in the presence of WRF with significantly improved survival (HR = 0.67). The improved survival in patients with concurrent WRF and hemoconcentration persisted after adjustment for age, sex, race, diabetes, hypertension, hemoglobin, sodium, BUN, eGFR, and length of stay. There was evidence suggesting that this was due to aggressive diuresis as opposed to just a prognostic marker. However, WRF predicts worse outcomes in HF as a population-level metric. Source: http://www.sciencedirect.com/