with kidney disease and heart failure
Over 50% of patients with heart failure also have kidney disease and this unstable combination results in poor survival, School of Medicine researchers report in the Journal of the American College of Cardiology.
The researchers studied 80,098 heart failure patients, combining data from 16 prior studies and comparing survival in those patients with and without kidney disease.
"A growing number of patients in the United States have both heart failure and kidney disease. Both of these conditions are costly and burdensome," says lead author Grace Smith, a student in the Department of Epidemiology and Public Health at the medical school. "While our study confirmed that heart failure patients with kidney disease had worse survival, we were surprised to discover that an extraordinary number of heart failure patients had kidney disease. Over half of the patients had at least mild disease and almost one-third had moderate to severe disease."
When followed for at least one year, 38% of patients with mild disease had died, and 51% with moderate to severe disease did not survive. "These mortality risks are comparable to risks attributed to deadly cancers," says Smith.
"Of even more concern is the lack of treatment options for patients with heart failure and kidney disease," says senior author Dr. Harlan Krumholz, professor of internal medicine, section of cardiology. "These patients have traditionally been excluded from clinical trials, most likely due to the severity of their illnesses.
"Our results emphasize that we need to understand outcomes in these patients in order to improve treatment strategies," says Krumholz. "This data may provide momentum for future research on interventions to change survival in this sick but substantial subgroup of heart failure patients."
Co-authors on the study include Judith Lichtman, Michael B. Bracken, Michael Shlipak, Christopher Phillips and Paul DiCapua.
-- By Karen Peart
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