{
    "abstract": "Chronic kidney disease (CKD) is defined by the KDIGO (Kidney Disease: Improving Global Outcomes) guideline as abnormal kidney structure or function, present for >3\u00a0months, with implications for health. KDIGO-defined CKD is associated with poor outcomes in patients with heart failure (HF). Less is known about whether these associations vary by left ventricular ejection fraction.\nThis study aims to determine the prevalence and outcomes of KDIGO-defined CKD in heart failure with preserved ejection fraction (HFpEF), heart failure with mildly reduced ejection fraction (HFmrEF), and heart failure with reduced ejection fraction (HFrEF).\nOf the 1,446,053 veterans with an HF diagnosis (1991-2017) in the national Veterans Affairs electronic health record data, 365,000 with data on EF had KDIGO-defined CKD or normal kidney function (NKF). CKD was defined as 2 values measured 90\u00a0days apart of estimated glomerular filtration rate (eGFR)\u00a0<60\u00a0mL/min/1.73\u00a0m\nAmong patients with HF and NKF, mortality occurred in 39%, 37%. and 41%, and HF hospitalization occurred in 12%, 15%, and 21% of those with HFpEF, HFmrEF. and HFrEF, respectively. Compared with NKF, CKD was associated with 16%, 19%, and 26% higher multivariable-adjusted risks for death in patients with HFpEF, HFmrEF, and HFrEF, respectively. Respective risks for HF hospitalization were 31%, 33%, and 32% higher. The eGFR-associated risks were incrementally higher with decreasing eGFR, except for eGFR\u00a0<15 mL/min/1.73 m\nThese findings based on KDIGO-defined CKD and NKF provide new information about the best estimates of true prevalence and outcomes of CKD in HFpEF, HFmrEF, and HFrEF.",
    "authors": [
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.",
            "firstname": "Samir",
            "initials": "S",
            "lastname": "Patel"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA.",
            "firstname": "Venkatesh K",
            "initials": "VK",
            "lastname": "Raman"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, Uniformed Services University, Washington, District of Columbia, USA.",
            "firstname": "Charles",
            "initials": "C",
            "lastname": "Faselis"
        },
        {
            "affiliation": "Department of Medicine, University of California, Los Angeles, California, USA. Electronic address: https://twitter.com/gcfmd.",
            "firstname": "Gregg C",
            "initials": "GC",
            "lastname": "Fonarow"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA; Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia, USA. Electronic address: https://twitter.com/PhilLamMD.",
            "firstname": "Phillip H",
            "initials": "PH",
            "lastname": "Lam"
        },
        {
            "affiliation": "Department of Medicine, Yale University, New Haven, Connecticut, USA.",
            "firstname": "Amiya A",
            "initials": "AA",
            "lastname": "Ahmed"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA; Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.",
            "firstname": "Paul A",
            "initials": "PA",
            "lastname": "Heidenreich"
        },
        {
            "affiliation": "Department of Cardiology of German Heart Center Charit\u00e9; German Centre for Cardiovascular Research partner site Berlin, Charit\u00e9 Universit\u00e4tsmedizin, Berlin, Germany; Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.",
            "firstname": "Stefan D",
            "initials": "SD",
            "lastname": "Anker"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, University of California, San Francisco, California, USA.",
            "firstname": "Prakash",
            "initials": "P",
            "lastname": "Deedwania"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA.",
            "firstname": "Charity J",
            "initials": "CJ",
            "lastname": "Morgan"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.",
            "firstname": "Sijian",
            "initials": "S",
            "lastname": "Zhang"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA; Department of Medicine, Uniformed Services University, Washington, District of Columbia, USA.",
            "firstname": "Hans",
            "initials": "H",
            "lastname": "Moore"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA. Electronic address: https://twitter.com/RangaswJ.",
            "firstname": "Janani",
            "initials": "J",
            "lastname": "Rangaswami"
        },
        {
            "affiliation": "Department of Medicine, University of Chicago, Chicago, Illinois, USA.",
            "firstname": "George",
            "initials": "G",
            "lastname": "Bakris"
        },
        {
            "affiliation": "Baylor Scott and White Research Institute, Dallas, Texas, USA; Department of Medicine, University of Mississippi, Jackson, Mississippi, USA. Electronic address: https://twitter.com/JavedButler1.",
            "firstname": "Javed",
            "initials": "J",
            "lastname": "Butler"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.",
            "firstname": "Helen M",
            "initials": "HM",
            "lastname": "Sheriff"
        },
        {
            "affiliation": "Department of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.",
            "firstname": "Richard M",
            "initials": "RM",
            "lastname": "Allman"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.",
            "firstname": "Qing",
            "initials": "Q",
            "lastname": "Zeng-Treitler"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Providence, Rhode Island, USA; Department of Medicine, Brown University, Providence, Rhode Island, USA.",
            "firstname": "Wen-Chih",
            "initials": "WC",
            "lastname": "Wu"
        },
        {
            "affiliation": "Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA. Electronic address: ali.ahmed@va.gov.",
            "firstname": "Ali",
            "initials": "A",
            "lastname": "Ahmed"
        }
    ],
    "conclusions": null,
    "copyrights": "Published by Elsevier Inc.",
    "doi": "10.1016/j.jchf.2024.11.007",
    "journal": "JACC. Heart failure",
    "keywords": [
        "KDIGO (Kidney Disease: Improving Global Outcomes)",
        "chronic kidney disease",
        "ejection fraction",
        "heart failure",
        "outcomes"
    ],
    "methods": null,
    "publication_date": "2025-02-07",
    "pubmed_id": "39918536",
    "results": "Among patients with HF and NKF, mortality occurred in 39%, 37%. and 41%, and HF hospitalization occurred in 12%, 15%, and 21% of those with HFpEF, HFmrEF. and HFrEF, respectively. Compared with NKF, CKD was associated with 16%, 19%, and 26% higher multivariable-adjusted risks for death in patients with HFpEF, HFmrEF, and HFrEF, respectively. Respective risks for HF hospitalization were 31%, 33%, and 32% higher. The eGFR-associated risks were incrementally higher with decreasing eGFR, except for eGFR\u00a0<15 mL/min/1.73 m",
    "title": "Outcomes of KDIGO-Defined CKD in U.S.\u00a0Veterans With HFpEF, HFmrEF, and\u00a0HFrEF.",
    "xml": "<Element 'PubmedArticle' at 0x788505329f30>"
}