Renal function trajectories in 'De Novo' heart failure with reduced ejection fraction: impact on outcomes

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Autori principali: Otero-García, O., Donoso-Trenado, V., de la Fuente-López, P., López-Vilella, R., Adarraga Gómez, J., Yebra-Pimentel Brea, C., Gallego-Latorre, G., Gómez Otero, M.I., Bouzas-Cruz, N., García-Vega, D., Almenar-Bonet, L., Gónzalez-Juanatey, J.R.
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Pubblicazione: Zenodo 2026
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author Otero-García, O.
Donoso-Trenado, V.
de la Fuente-López, P.
López-Vilella, R.
Adarraga Gómez, J.
Yebra-Pimentel Brea, C.
Gallego-Latorre, G.
Gómez Otero, M.I.
Bouzas-Cruz, N.
García-Vega, D.
Almenar-Bonet, L.
Gónzalez-Juanatey, J.R.
author_facet Otero-García, O.
Donoso-Trenado, V.
de la Fuente-López, P.
López-Vilella, R.
Adarraga Gómez, J.
Yebra-Pimentel Brea, C.
Gallego-Latorre, G.
Gómez Otero, M.I.
Bouzas-Cruz, N.
García-Vega, D.
Almenar-Bonet, L.
Gónzalez-Juanatey, J.R.
contents Aims Heart failure (HF) often coexists with chronic kidney disease (CKD), impacting prognosis. This study aims to evaluate renal function trajectories and their impact on major clinical outcomes in a cohort of patients hospitalised for 'de novo' HF with reduced ejection fraction (HFrEF). Methods This is a prospective cohort study that included patients hospitalised for 'de novo' HFrEF at two university hospitals. Renal function was assessed using the CKD-Epidemiology Collaboration formula. Total mortality and the combined total mortality and HF readmissions were evaluated during follow-up. Results Of 370 patients, 306 were eligible. At discharge, 24.6% had estimated glomerular filtration rate (eGFR) <45mL/min/1.73 m2. Higher eGFR at discharge was associated with better outcomes. During follow-up, 79.1% showed eGFR =45mL/min/1.73 m2. Patients with stable or improved eGFR had lower total mortality and HF readmission rates. Factors associated with renal function improvement or stabilisation included less prior CKD, hypertension and younger age, higher eGFR values at discharge and more use of quadruple therapy at the end of uptitration period. Conclusions In patients with 'de novo' HFrEF, renal function deterioration at discharge correlated with poorer outcomes. However, stabilisation or improvement during follow-up was linked to better prognosis. Routine renal function assessment is crucial in HFrEF management, guiding personalised treatment strategies to mitigate renal function decline and improve patient care. © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
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spellingShingle Renal function trajectories in 'De Novo' heart failure with reduced ejection fraction: impact on outcomes
Otero-García, O.
Donoso-Trenado, V.
de la Fuente-López, P.
López-Vilella, R.
Adarraga Gómez, J.
Yebra-Pimentel Brea, C.
Gallego-Latorre, G.
Gómez Otero, M.I.
Bouzas-Cruz, N.
García-Vega, D.
Almenar-Bonet, L.
Gónzalez-Juanatey, J.R.
Cardiomyopathies
HEART FAILURE
Heart Failure
Systolic
Aims Heart failure (HF) often coexists with chronic kidney disease (CKD), impacting prognosis. This study aims to evaluate renal function trajectories and their impact on major clinical outcomes in a cohort of patients hospitalised for 'de novo' HF with reduced ejection fraction (HFrEF). Methods This is a prospective cohort study that included patients hospitalised for 'de novo' HFrEF at two university hospitals. Renal function was assessed using the CKD-Epidemiology Collaboration formula. Total mortality and the combined total mortality and HF readmissions were evaluated during follow-up. Results Of 370 patients, 306 were eligible. At discharge, 24.6% had estimated glomerular filtration rate (eGFR) <45mL/min/1.73 m2. Higher eGFR at discharge was associated with better outcomes. During follow-up, 79.1% showed eGFR =45mL/min/1.73 m2. Patients with stable or improved eGFR had lower total mortality and HF readmission rates. Factors associated with renal function improvement or stabilisation included less prior CKD, hypertension and younger age, higher eGFR values at discharge and more use of quadruple therapy at the end of uptitration period. Conclusions In patients with 'de novo' HFrEF, renal function deterioration at discharge correlated with poorer outcomes. However, stabilisation or improvement during follow-up was linked to better prognosis. Routine renal function assessment is crucial in HFrEF management, guiding personalised treatment strategies to mitigate renal function decline and improve patient care. © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
title Renal function trajectories in 'De Novo' heart failure with reduced ejection fraction: impact on outcomes
topic Cardiomyopathies
HEART FAILURE
Heart Failure
Systolic
url https://doi.org/10.1136/openhrt-2025-003193