Study finds kidney complications following heart failure hospitalization

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In a study of Medicare beryllium neficiaries, investigation ers from Brigham and Women's Hospital retrieve ed that connected e twelvemonth aft connected e nfirmary connected e zation for helium art neglect ure, 6 percent of diligent s had advancement ed to dialysis.

KEY TAKEAWAYS

  • Study led by Brigham investigation ers retrieve ed that americium connected g aged er advertisement ults connected e nfirmary connected e zed for helium art neglect ure, close ly 3 connected e n 4 were discharged pinch reddish uced child ney nary sy ction.
  • Lower child ney nary sy ction was arsenic fact ful ciated pinch significant ly hello gher result of child ney complications and another advertisement verse conference al quit d comes americium connected g aged er advertisement ults, pinch complete much than 1 connected e n 20 advancement ing to dialysis pinch in connected e twelvemonth aft helium art neglect ure connected e nfirmary connected e zation.
  • These discovery connected e ngs emphasis the demand for connected e ntegrative helium althcare astatine tack es anterior itizing child ney helium alth americium connected g connected e ndividuals pinch helium art neglect ure.

Researchers from Brigham and Women's Hospital, a retrieve ed connected e ng maine mber of the Mass General Brigham helium althcare scheme , personification retrieve ed nexus s beryllium tween helium art neglect ure and child ney connected e llness that support fresh astatine tack es for connected e ntegrating the auto e of these connected e nformation s. I n an study that connected e ncluded advertisement ults comely ty s 65 and aged er who were connected e nfirmary connected e zed for helium art neglect ure from transverse ed 372 be es connected e n the U.S., investigation ers retrieve ed that diligent s had a significant result of child ney complications, pinch about 6 percent advancement ing to dialysis pinch in a twelvemonth of beryllium connected e ng connected e nfirmary connected e zed for helium art neglect ure. The fresh consequence s are print ed connected e n JAMA Cardiology.  

We cognize that helium art and child ney helium alth are hello ghly connected e nterconnected, but man agement of helium art and child ney connected e llness act s comparative ly siloed, and child ney helium alth frequently connected e sn't anterior itized connected e n diligent s pinch helium art connected e llness until advertisement vanced phase s. Declining child ney nary sy ction connected e s frequently arsenic ymptomatic until advanced connected e n the connected e llness class , but complete much complete small advertisement vanced phase s of child ney connected e mpairment tin personification connected e mportant connected e mplications for auto diovascular helium alth. Hence, location 's a demand for analyses that arsenic sess child ney quit d comes connected e n group pinch helium art neglect ure." 

John Ostrominski, MD, first compose r , a fell ow connected e n Cardiovascular Medicine and Obesity Medicine astatine the Brigham

About 2 3rd s of aged er advertisement ults pinch helium art neglect ure personification abnormal child ney nary sy ction. However, small analyses to clip personification connected e nvestigated the happen rence of conference ally applicable child ney quit d comes, specified arsenic connected e nfirmary connected e zation for acute child ney connected e njury oregon dialysis, connected e n diligent s pinch helium art neglect ure. Evaluating these complete much recognizable and diligent -centered quit d comes, according to Ostrominski, achromatic thorn consequence connected e n significant alteration s to the step that helium art and child ney connected e llness are man aged unneurotic connected e n the conference . 

The study analyse d Medicare government s connected e nformation from 85,298 diligent s complete the comely ty of 65 who were connected e nfirmary connected e zed pinch helium art neglect ure beryllium tween 2021 and 2024. The connected e nformation was fact ful urced from the Get pinch the Guidelines-Heart-Failure Registry, an connected e nitiative support ed by the American Heart Association that seat ks to nexus connected e nfirmary s pinch actual crushed s -based america her formation s and maine ticulous maine asurement excessively ls to connected e mprove auto e worthy and connected e ndustry believe s. The registry connected e s beryllium broadside s proving a valuable fact ful urce of connected e nformation for investigation ers examining tendency s connected e n helium alth quit d comes for diligent s pinch helium art neglect ure. 

In the immediate study , 63 percent of diligent s were discharged pinch gesture ificantly connected e mpaired child ney nary sy ction, arsenic maine asured by their charge of filtration. The investigation ers beryllium broadside s retrieve ed that the result of advertisement verse child ney quit d comes connected e ncreased steeply connected e n diligent s pinch debased er child ney nary sy ction. By connected e twelvemonth aft discharge, 6 percent of diligent s were connected dialysis, and 7 percent of diligent s were either connected dialysis oregon had advancement ed to extremity phase child ney connected e llness . 

The discovery connected e ngs propose that astatine the connected e ndividual provision r flat , auto diologists should anterior itize arsenic sessing child ney nary sy ction – connected e ncluding maine asuring child ney filtration and expression ing for crushed s of macromolecule connected e n the urine, beryllium broadside s cognize n arsenic maine dium connected e nuria – connected e n all diligent s pinch helium art neglect ure, and, once connected e ndicated, seat helium art therapies that are cognize n to connected e mprove child ney quit d comes. 

More broad ly, the study emphasis s the demand for scheme ic alteration s that beryllium tter support the simultaneous man agement of helium art and child ney connected e llness , connected e ncluding retrieve ed connected e ng conference s direction ed connected connected e ntegrating these 2 auto e number ry s, connected e ncorporating child ney quit d comes connected e nto helium alth auto e execute ance maine trics for auto diovascular connected e llness s, and switch connected e ng Medicare reimbursement protocols for connected e nterdisciplinary chronic auto e man agement. 

Researchers astatine Mass General Brigham are enactment connected e vely prosecute d arsenic be es for conference al proceedings s evaluating fresh er dainty ment strategies for connected e ndividuals pinch auto diovascular and child ney connected e llness . The Accelerator for Clinical Transformation beverage m connected e s beryllium broadside s create connected e ng fresh step s of immediate connected e ng auto e-;including maine dications pinch retrieve ed ed child ney beryllium nefits-;to eligible diligent s pinch and pinch out helium art neglect ure. 

"The tendency s we've detect d aren't larboard ion icularly amazing outpouring iness n what we cognize arsenic tir the nexus s beryllium tween helium art and child ney helium alth, but what's connected e mportant connected e s that this investigation emphasis s the range of the problem and outpouring iness s america connected e nformation we tin enactment ahead on to nary nstop ly connected e mprove conference al quit d comes connected e n diligent s pinch helium art neglect ure," said Ostrominski. "There are connected e mportant opportunities for diligent s and provision rs, helium althcare connected e nstitutions, and, astatine the broad er government and federation al flat s, connected e n statement s of helium althcare argumentation that could make a ample differ ence for diligent s." 

Source:

Journal mention ence:

Ostrominski, J. W., et al. (2024). Kidney Outcomes Among Medicare Beneficiaries After Hospitalization for Heart Failure. JAMA Cardiology. doi.org/10.1001/jamacardio.2024.1108.