Long-term changes in renal function and perfusion in heart failure patients with reduced ejection fraction

Abstract

Little is known about the natural course of renal function and renal hemodynamics in heart failure patients with reduced ejection fraction (HFREF).We prospectively studied effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) in 73 HFREF patients with I-125-iothalamate/I-131-hippuran clearances with a mean follow-up of 34.6 +/- A 4.4 months. Fifteen percent were female, with age 58 +/- A 12 years and left ventricular ejection fraction (LVEF) 29 +/- A 10 %. Baseline GFR was 81 +/- A 23 mL/min/1.73 m(2) and declined 0.6 +/- A 4.7 mL/min/1.73 m(2) per year. Baseline ERPF was 292 +/- A 83 mL/min/1.73 m(2) and declined 4.3 +/- A 19 mL/min/1.73 m(2) per year. Of the baseline variables, older age and high urinary kidney injury molecule-1 were the only variables associated with GFR decline (p