Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Cardiology. https://doi.org/10.1001/jamacardio.2024.1108 Dr. John Ostrominski et al.
Points
- A study of 85,298 Medicare beneficiaries hospitalized for heart failure (HF) revealed a 6% progression to dialysis within one year after HF hospitalization.
- 63% of patients were discharged with an estimated glomerular filtration rate (eGFR) less than 60 mL/min per 1.73 m2, and adverse kidney outcomes increased sharply with lower discharge eGFR.
- Incident dialysis increased significantly with the lower discharge eGFR category, highlighting the substantial risk of kidney complications in older adults following HF hospitalization.
- Lower discharge eGFR was independently associated with higher readmission rates for dialysis, dialysis or end-stage kidney disease, acute kidney injury, and all-cause mortality and readmission.
- Findings emphasize the critical need for healthcare strategies prioritizing kidney health in older adults with HF, given the substantial risk of dialysis and other kidney complications early after hospitalization.
Summary
In a retrospective cohort study of 85,298 Medicare beneficiaries hospitalized for heart failure (HF), it was found that 6% of individuals progressed to dialysis within one year after HF hospitalization. Additionally, 63% of the patients were discharged with an estimated glomerular filtration rate (eGFR) less than 60 mL/min per 1.73 m2, and the risk of adverse kidney outcomes increased steeply with lower discharge eGFR. The study, conducted between January 1, 2014, and December 31, 2018, revealed that incident dialysis increased significantly with lower discharge eGFR category, emphasizing the substantial risk of kidney complications in older adults following HF hospitalization.
The analysis, which included adults aged 65 years or older, demonstrated that lower discharge eGFR was independently associated with a higher rate of readmission for dialysis, dialysis or end-stage kidney disease, and acute kidney injury (AKI), as well as all-cause mortality, all-cause readmission, and HF readmission. The study’s findings underscore the critical need for healthcare strategies that prioritize kidney health in this high-risk population, given the substantial risk of dialysis and other kidney complications early after hospitalization for HF.
In conclusion, the study highlighted the significant incidence of adverse kidney outcomes among older adults following HF hospitalization, with 6% progressing to dialysis within one year. The steep increase in adverse kidney outcomes with lower discharge eGFR underscores the importance of prioritizing kidney health in the management of this high-risk population, emphasizing the need for comprehensive healthcare approaches that address the substantial risk of kidney complications in older adults with HF.
Link to the article: https://jamanetwork.com/journals/jamacardiology/article-abstract/2819215
References Ostrominski, J. W., Greene, S. J., Patel, R. B., Solomon, N. C., Chiswell, K., DeVore, A. D., Butler, J., Heidenreich, P. A., Huang, J. C., Kittleson, M. M., Joynt Maddox, K. E., Linganathan, K. K., McDermott, J. J., Owens, A. T., Peterson, P. N., Solomon, S. D., Vardeny, O., Yancy, C. W., Fonarow, G. C., & Vaduganathan, M. (2024). Kidney Outcomes Among Medicare Beneficiaries After Hospitalization for Heart Failure. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2024.1108
