Predictive Value of Renal Venous Flow Profiles for Adverse Outcomes in Right Heart Failure

University of Giessen421 enrolled

Overview

Predictive value of renal venous flow profiles for adverse outcomes in patients with right heart failure

Persistent congestion with deteriorating renal function is an important cause of adverse outcomes in heart failure. The investigators aimed to characterize new Doppler ultrasonography approaches to evaluate the continuum of renal congestion. Pulmonary hypertension is the most common precursor to right heart failure and thus represents an ideal scenario to study congestion. The second cohort comprises consecutive Cardiology inpatients aged ≥18 years with a new or pre-existing diagnosis of heart failure who are referred to the consultant nephrologist with a history of diuretic-resistant fluid overload and impaired renal function. The investigators choose patients with heart failure to broaden the findings to the most common clinical entity of right ventricular failure.

Study Type

OBSERVATIONAL

Enrollment

421

Conditions

Pulmonary Hypertension Cardiorenal Syndrome Heart Failure

Interventions

No interventionDIAGNOSTIC_TEST

No intervention

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Pulmonary hypertension cohort: Exclusion Criteria: * CKD stage 5 (KDIGO) * pre-existing acute kidney injury (acute kidney injury was defined as an increase in serum creatinine by ≥ 0.3 mg/dl within 48 hours or to ≥ 1.5 times baseline within the prior 7 days, as determined by all available serum creatinine values from hospital and outpatient medical records within the previous 90 days) * Non-end stage renal disease patients with extracorporeal or peritoneal ultrafiltration for treatment of diuretic-resistant fluid overload * Patients with primary kidney disease (e.g., glomerulonephritis, autosomal dominant polycystic kidney disease, postrenal obstruction) * solid-organ transplant recipients * use of non-steroidal inflammatory drugs within 72 hours before right heart catheterization Heart failure cohort: Exclusion criteria same as in the discovery cohort except pre-existing acute kidney injury * Patients with mechanical assist devices are excluded

Locations (1)

University Clinic Giessen and Marburg - Campus Giessen

Giessen, Hesse, Germany

Outcomes

Primary Outcomes

Rate of pulmonary hypertension-related morbidity and all-cause mortality (pulmonary hypertension cohort)

Any hospitalization for worsening of pulmonary hypertension, lung transplantation, or need for escalation of pulmonary hypertension-specific therapy, and death from any cause

Time frame: 1 year post-discharge

First occurrence of worsening heart failure and first occurrence of need for renal replacement therapy (heart failure cohort)

Unscheduled hospitalization or unscheduled office visit for heart failure and new onset renal replacement therapy

Time frame: 1 year post-discharge

Data from ClinicalTrials.gov

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