Evaluation, clinical and prognostic role of chronic kidney disease markers in outpatients with heart failure in real-world practice: data from the PRIORITY-HF study
Year: 2025
Type: article
Abstract: Aim. To evaluate markers of chronic kidney disease (CKD) and their clinical and prognostic role in outpatients with heart failure (HF) based on real-world data. Material and methods. This retrospective analysis of data from the prospective observational multicenter registry study of patients with heart failure in Russia (PRIORITY-HF) was performed, including 19981 patients. To assess CKD markers, the following data obtained at Visit 1 were taken into account: "Has the diagnosis of Chronic Kidney Disease (CKD) been confirmed?", "CKD stage", "CKD-EPI Estimated glomerular filtration rate (eGFR)", "Creatinine", "Albumin" or "Albumin/ creatinine ratio" in a single urine portion. eGFR values entered in case report form were compared with the CKD-EPI 2021 eGFR values based on the patient’s sex, age and the entered serum creatinine (aGFR). Clinical characteristics, therapy after Visit 1 and prognosis were compared in patients with CKD and depending on aGFR value. Results. The following diagnostic problems were identified: incorrect GFR estimation with more frequent underestimation of values and insufficient assessment of albuminuria. CKD was noted as a concomitant diagnosis in 44,7% of patients with HF, but aGFR <60 ml/min/1,73 m2 was determined in 30,8% of cases. Groups with both reported CKD and aGFR were characterized by a more severe HF course, a greater burden of most cardiovascular and non-cardiovascular (obesity, diabetes mellitus and anemia) comorbidities. A decrease in prescription rate of most classes of guideline-directed medical therapy for HF and quadruple therapy with aGFR <30 ml/min/1,73 m2 was noted. Both CKD and a decrease in aGFR <60 ml/min/1,73 m2 were associated with a higher rate of adverse events. A decrease in eGFR by every 10 ml/min/1,73 m2 was significantly associated with all adverse outcomes with extensive adjustment. Conclusion. The high prevalence of CKD in the cohort of HF patients, the identified diagnostic problems, a more severe clinical course of HF, and an unfavorable prognosis emphasize the need for comprehensive measures to increase physician awareness and optimize the implementation of guidelines in real-world practice.
Source: Russian Journal of Cardiology
Authors: E. V. Shlyakhto, Yu. N. Belenkov, S. A. Boytsov, S. V. Villevalde, A. S. Galyavich, M. G. Glezer, N. E. Zvartau, Zh. D. Kobalava, Yu. M. Lopatin, V. Yu. Mareev, S. N Tereshchenko, I. V. Fomin, O. L. Barbarash, N. G. Vinogradova, D. V. Duplyakov, I. V. Zhirov, E. D. Kosmacheva, V. A. Nevzorova, O. M. Reitblat, A. E. Soloveva, E. A. Medvedeva, E. A. Zorina
Institutions: Federal Almazov North-West Medical Research Centre, Sechenov University, National Medical Research Center of Cardiology, Kazan State Medical University, Peoples' Friendship University of Russia, Volgograd State Medical University, Lomonosov Moscow State University, Privolzhsky Research Medical University, Samara State Medical University, Vladivostok State Medical University
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415032037