![]() All patients in this study were aged 35 to 95 years old with signs and symptoms related to CHF. The diagnosis of CHF was based on the 2005 ACC/AHA guideline update for the diagnosis and management of CHF in the adult. In consequence, we conducted the retrospective study to explore the relationship between the BUN/Scr ratio and the prognosis of patients with HF complicated with renal injury.Ĭonsecutive admissions from March 2006 to June 2014 to the cardiology department at the Guang’anmen Hospital affiliated to China Academy of Chinese Medical Sciences with an admitting diagnosis of CHF were reviewed. BUN/Scr can better reflect renal function and evaluate the prognosis of patients with CHF. On the contrary, intrinsic renal disease is the irreversible nephron loss, urea clearance rate, and glomerular filtration rate were decreased simultaneously, resulting in normal BUN/Scr. Activation of the sympathetic nervous system and the renin–angiotensin–aldosterone system (RAAS) decreased urea excretions, and activation of neurohormones increased urea absorption, while creatinine could pass freely through the glomerulus without absorption, increasing BUN/Scr. The insufficient renal perfusion, due to the dysfunction of ventricular systolic and/ or diastolic function in patients with CHF, leads to pre-renal acute kidney injury. Fortunately, BUN/Scr ratio are recognized indicators of renal insufficiency and there are a few previous reports have shown that the BUN/Scr ratio is associated with prognosis of CHF and is an independent predictor of all-cause mortality In brief, BUN and Scr alone have their limitations. Nevertheless, BUN is not an accurate index of renal function because excess protein intake, body fluid depletion, heart failure, increased catabolism, and use of diuretics increase BUN levels, besides, Scr has been shown to underestimate renal function. In the meantime, blood urea nitrogen (BUN) and serum creatinine (Scr) are the classic indicators of renal function. As early as 1836, Robert Bright had decribed the interdependent relationship between heart and kindey, with the continuous development of research, the mechanism of kidney disease in patients with heart failure (HF) is gradually concluded to be mostly related to the hemodynamic interactions, neurohormonal activation and so on. The prevalence of heart failure increases with age: from around 1% for those aged 10% in those aged 70 years or over, which had become a global clinical and public health challenge.ĬHF patients often have complications, the most important comorbidity was kidney damage. ConclusionsīUN/Scr ratio is related to the poor prognosis of patients with CHF, and is an independent predictor of all-cause death.Ĭhronic heart failure (CHF) is a clinical syndrome of cardiac output and/or elevated intracardiac pressures at rest or during stress due to structural and/or functional cardiac abnormality. Subgroup analysis showed that the relationship between BUN/Scr and the prognosis of CHF was influenced by NYHA and eGRF ( P < 0.05). After multivariate analysis, COX regression model showed that the mortality of patients with BUN/Scr ≥ 19.37 was 1.885 times that of patients with BUN/Scr < 19.37. The results of Kaplan–Meier survival curve showed that the mortality rate of patients with ratio ≥ 19.37 was higher than that of patients with ratio < 19.37. Through ROC analysis of 504 subjects, the cutoff value of BUN/Scr was 19.37. The baseline data of 504 patients were analyzed and found that the median follow up was 683. Univariate analysis was performed on all the variables affecting the patient's prognosis, and the variables with P < 0.05 were put into Cox regression model, and subgroup analysis was performed on the variables that might affect the patient’s prognosis. The long-term mortality of the two groups was evaluated, and Kaplan–Meier survival curve was drawn. The main end point was defined as all-cause death. The baseline data were analyzed, and the cutoff value was obtained by receiver operator characteristic curve (ROC) analysis, according to the cutoff value, all the participants were divided into two groups, BUN/Scr < 19.37 group (280 cases) and BUN/Scr ≥ 19.37 group (224 cases). MethodsĪ retrospective analysis of 504 patients hospitalized in Guang 'anmen Hospital, Chinese Academy of Traditional Chinese Medicine from March 2006 to June 2014 was conducted. ![]() To explore the correlation between Blood urea nitrogen to creatinine ratio (BUN/Scr ratio) and prognosis of patients with chronic heart failure complicated with renal injury.
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