Cardiorenal Syndrome, Heart Failure, Pulmonary Hypertension
Conditions
Keywords
Renal Doppler ultrasonography, Venous Congestion
Brief summary
Predictive value of renal venous flow profiles for adverse outcomes in patients with right heart failure
Detailed description
Persistent congestion with deteriorating renal function is an important cause of adverse outcomes in heart failure. The investigators aimed to characterize new Doppler ultrasonography approaches to evaluate the continuum of renal congestion. Pulmonary hypertension is the most common precursor to right heart failure and thus represents an ideal scenario to study congestion. The second cohort comprises consecutive Cardiology inpatients aged ≥18 years with a new or pre-existing diagnosis of heart failure who are referred to the consultant nephrologist with a history of diuretic-resistant fluid overload and impaired renal function. The investigators choose patients with heart failure to broaden the findings to the most common clinical entity of right ventricular failure.
Interventions
DIAGNOSTIC_TESTNo intervention
No intervention
Sponsors
University of Giessen
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Pulmonary hypertension cohort:
Exclusion criteria
* CKD stage 5 (KDIGO) * pre-existing acute kidney injury (acute kidney injury was defined as an increase in serum creatinine by ≥ 0.3 mg/dl within 48 hours or to ≥ 1.5 times baseline within the prior 7 days, as determined by all available serum creatinine values from hospital and outpatient medical records within the previous 90 days) * Non-end stage renal disease patients with extracorporeal or peritoneal ultrafiltration for treatment of diuretic-resistant fluid overload * Patients with primary kidney disease (e.g., glomerulonephritis, autosomal dominant polycystic kidney disease, postrenal obstruction) * solid-organ transplant recipients * use of non-steroidal inflammatory drugs within 72 hours before right heart catheterization Heart failure cohort:
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of pulmonary hypertension-related morbidity and all-cause mortality (pulmonary hypertension cohort) | 1 year post-discharge | Any hospitalization for worsening of pulmonary hypertension, lung transplantation, or need for escalation of pulmonary hypertension-specific therapy, and death from any cause |
| First occurrence of worsening heart failure and first occurrence of need for renal replacement therapy (heart failure cohort) | 1 year post-discharge | Unscheduled hospitalization or unscheduled office visit for heart failure and new onset renal replacement therapy |
Countries
Germany
Outcome results
None listed