Renal Function and Exercise Training in AmbulatoryHeart Failure Patients With a Reduced Ejection Fraction
Section snippets
Methods
The study design12 and primary results13, 14 of the HF-ACTION trial (ClinicalTrials.gov Number: NCT00047437) have been previously reported. HF-ACTION was a multicenter, randomized, placebo-controlled trial designed to assess the long-term efficacy and safety of a structured exercise intervention in medically stable outpatients with long-term HFrEF. A total of 2,331 patients were recruited from 82 centers in the United States, Canada, and France from April 2003 to February 2007. Enrollment
Results
A total of 2,091 ambulatory HFrEF patients (90%) had sCr measured at baseline and were included in the final analytical cohort (Supplementary Table 1). At the time of enrollment, 41% of patients (n = 856) met the prespecified definition for CKD (i.e., eGFR <60 ml/min/m2; Figure1). In contrast, less than 5% of patients (n = 101) had an eGFR <30 ml/min/m2 (i.e., Stage 4 and/or 5).
Patients with comorbid CKD tended to be significantly older, were more likely to self-identify as white, and had a
Discussion
The present analysis found the prevalence of comorbid CKD to be approximately 40% in outpatients with HFrEF. There are 3 commonly used GFR estimating equations for sCr, including the Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD), and CKD-EPI, which were derived and validated in disparate study populations and as a result may provide different estimates of the prevalence of CKD and have variable accuracy and prognostic value. The purported advantage of the CKD-EPI equation is
Disclosure
APA is supported by a National Heart, Lung, and Blood Institute (NHLBI) T32 postdoctoral training grant (5T32HL069749). All other authors declare no relevant financial disclosures.
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