{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:58:12Z","timestamp":1773788292063,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":1105,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"US Department of Veterans Affairs Clinical Sciences R&D Service","award":["IK2 CX002105"],"award-info":[{"award-number":["IK2 CX002105"]}]},{"DOI":"10.13039\/100000062","name":"National Institutes of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["K24 DK110427"],"award-info":[{"award-number":["K24 DK110427"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Kidney function changes dynamically during AHF treatment, but risk factors for and consequences of worsening renal function (WRF) at hospital admission are uncertain. We aimed to determine the significance of WRF at admission for acute heart failure (AHF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We evaluated a subgroup of 406 patients from The Acute Kidney Injury Neutrophil gelatinase\u2013associated lipocalin Evaluation of Symptomatic heart failure Study (AKINESIS) who had serum creatinine measurements available within 3 months before and at the time of admission. Admission WRF was primarily defined as a 0.3 mg\/dL or 50% creatinine increase from preadmission. Alternative definitions evaluated were a \u22650.5 mg\/dL creatinine increase, \u226525% glomerular filtration rate decrease, and an overall change in creatinine. Predictors of admission WRF were evaluated. Outcomes evaluated were length of hospitalization, a composite of adverse in-hospital events, and the composite of death or HF readmission at 30, 90, and 365 days. Biomarkers' prognostic ability for these outcomes were evaluated in patients with admission WRF. One-hundred six patients (26%) had admission WRF. These patients had features of more severe AHF with lower blood pressure, higher BUN, and lower serum sodium concentrations at admission. Higher BNP (odds ratio [OR] per doubling 1.16\u20131.28, 95% confidence interval [CI] 1.00\u20131.55) and lower diastolic blood pressure (OR 0.97\u20130.98, 95% CI 0.96\u20130.99) were associated with a higher odds for the three definitions of admission WRF. The primary WRF definition was not associated with a longer hospitalization, but alternative WRF definitions were (1.3 to 1.6 days longer, 95% CI 1.0\u20132.2). WRF across definitions was not associated with a higher odds of adverse in-hospital events or a higher risk of death or HF readmission. In the subset of patients with WRF, biomarkers were not prognostic for any outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Admission WRF is common in AHF patients and is associated with an increased length of hospitalization, but not adverse in-hospital events, death, or HF readmission. Among those with admission WRF, biomarkers did not risk stratify for adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14221","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T03:44:29Z","timestamp":1667447069000},"page":"532-541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Implications of Worsening Renal Function Before Hospitalization for Acute Heart Failure"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6122-1152","authenticated-orcid":false,"given":"Nicholas","family":"Wettersten","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, San Diego Veterans Affairs Medical Center , San Diego, California ,","place":["USA"]},{"name":"Division of Cardiovascular Medicine, University of California, San Diego , La Jolla, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Duff","sequence":"additional","affiliation":[{"name":"School of Medicine, University College Dublin , Dublin ,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Mitsui Memorial Hospital , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk J.","family":"van Veldhuisen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Groningen, University of Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Athens University Hospital Attikon, University of Athens , Athens ,","place":["Greece"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Henry Ford Hospital System , Detroit, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Hogan","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and Acute Care Surgical Services, VCU Medical Center, Virginia Commonwealth University , Richmond, Virginia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Kontos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, VCU Medical Center, Virginia Commonwealth University , Richmond, Virginia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chad M.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Kansas Medical Center , Kansas City, Kansas ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard A.","family":"M\u00fceller","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, University Medical Center G\u00f6ttingen, University of G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Birkhahn","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, New York Methodist , Brooklyn, New York ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pam","family":"Taub","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of California, San Diego , La Jolla, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary M.","family":"Vilke","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of California, San Diego , La Jolla, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mater Misericordiae University Hospital, University College Dublin , Dublin ,","place":["Ireland"]},{"name":"Department of Cardiology, St. Vincent's University Hospital , Dublin ,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niall","family":"Mahon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vincent's University Hospital , Dublin ,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Nu\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Valencia, INCLIVA, University of Valencia , Valencia ,","place":["Spain"]},{"name":"CIBER in Cardiovascular Diseases , Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Briguori","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Interventional Cardiology, Mediterranea Cardiocentro , Naples ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Passino","sequence":"additional","affiliation":[{"name":"Department 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