Clinical studyElevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failure
Section snippets
Patients
We performed a pooled analysis of the Comparative trial (11) and the Prospective Randomized Evaluation of Cardiac Ectopy with Dobutamine or Nesiritide Therapy (PRECEDENT) study (12), two randomized trials of nesiritide (human B-type natriuretic peptide) in patients with decompensated heart failure. The study protocols have been described in detail elsewhere 11, 12. In brief, in the Comparative trial (11), 305 patients admitted for acute decompensated heart failure were randomly assigned to
Results
Baseline clinical characteristics were similar among the patients in the two trials, with the exception that more patients in the PRECEDENT trial received digoxin, beta-blockers, and ACE inhibitors or angiotensin II receptor inhibitors (Table 1).
Discussion
In the present study, we sought to determine whether the severity of renal dysfunction in hospitalized patients with decompensated heart failure provided prognostic information on outcomes after discharge. We found blood urea nitrogen and the blood urea nitrogen/creatinine ratio to be independent predictors of all-cause mortality. Serum creatinine and estimated creatinine clearance were not associated with mortality after adjustment for other covariates.
Renal function is an important
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