83 - Multi-Year Kidney Function Evaluation in Heart Failure Patients
Description/Abstract/Artist Statement
- 1. Introduction
a. Heart failure (HF) and chronic kidney disease (CKD) are common comorbidities, resulting in an interplay between cardiac function and decline in kidney function. Pulmonary artery pressure (PAP) monitoring systems, such as the CardioMEMS device, offer a potentially valuable mechanism for surveilling HF and mitigating CKD progression. Our two-year cohort analysis examines the efficacy of CardioMEMS in preserving kidney function among HF patients with CKD.
- 2. Methods -
a. A total of 100 patients from the John Muir Hospital dataset were enrolled. The cohort was comprised of 59 males (59%) and 41 females (41%). Hypertension (HTN) was prevalent (85%), and 59% of participants had diabetes mellitus (DM). Regarding heart failure classification, 75% had HF with preserved ejection fraction (HFpEF), and 25% had HF with reduced ejection fraction (HFrEF).
- 3. Results –
a. In two years, CardioMEMS patients demonstrated a mean eGFR of 40.14 mL/min/1.73 m2, significantly higher than the 32.58 mL/min/1.73 m2 observed in the Non-CardioMEMS group (t(98) = 2.798, p < 0.05). By the end of the 2-year period, there was a net 7.56 mL/min/1.73 m2 GFR difference. CardioMEMS CKD Stage 3 patients (n = 34) showed a stable eGFR, increasing from 42.68 to 44.08 over the 2-year time period, whereas non-CardioMEMS patients showed a decline in GFR from 45.16 to 36.16 over the same two-year time period. In CKD Stage 4 patients, CardioMEMS patients (n = 16) showed a marked improvement from 23.18 to 31.75 mL/min/1.73 m2, whereas non-CardioMEMS patients (n=12) showed a decrease in GFR from 23.33 to 21.17 over the same time period.
- Conclusion –
- In this two-year cohort analysis of HF patients with CKD Stage 3 and 4, CardioMEMS was associated with statistically significant preservation or improvement in renal function. These findings suggest the potential value of Pulmonary Artery Pressure-guided management of heart failure in high-risk populations to slow the rate of renal decline via improved hemodynamic monitoring and proactive management. Future studies involving larger patient populations in additional centers will be valuable to further evaluate these findings and to explore optimal management strategies for heart failure patients with chronic kidney disease.
Faculty Advisor/Mentor
Yousef Hindi
Faculty Advisor/Mentor Department
Cardiology
College Affiliation
Eastern Virginia Medical School
Presentation Type
Poster
Disciplines
Medical Physiology | Other Medical Sciences
83 - Multi-Year Kidney Function Evaluation in Heart Failure Patients
- 1. Introduction
a. Heart failure (HF) and chronic kidney disease (CKD) are common comorbidities, resulting in an interplay between cardiac function and decline in kidney function. Pulmonary artery pressure (PAP) monitoring systems, such as the CardioMEMS device, offer a potentially valuable mechanism for surveilling HF and mitigating CKD progression. Our two-year cohort analysis examines the efficacy of CardioMEMS in preserving kidney function among HF patients with CKD.
- 2. Methods -
a. A total of 100 patients from the John Muir Hospital dataset were enrolled. The cohort was comprised of 59 males (59%) and 41 females (41%). Hypertension (HTN) was prevalent (85%), and 59% of participants had diabetes mellitus (DM). Regarding heart failure classification, 75% had HF with preserved ejection fraction (HFpEF), and 25% had HF with reduced ejection fraction (HFrEF).
- 3. Results –
a. In two years, CardioMEMS patients demonstrated a mean eGFR of 40.14 mL/min/1.73 m2, significantly higher than the 32.58 mL/min/1.73 m2 observed in the Non-CardioMEMS group (t(98) = 2.798, p < 0.05). By the end of the 2-year period, there was a net 7.56 mL/min/1.73 m2 GFR difference. CardioMEMS CKD Stage 3 patients (n = 34) showed a stable eGFR, increasing from 42.68 to 44.08 over the 2-year time period, whereas non-CardioMEMS patients showed a decline in GFR from 45.16 to 36.16 over the same two-year time period. In CKD Stage 4 patients, CardioMEMS patients (n = 16) showed a marked improvement from 23.18 to 31.75 mL/min/1.73 m2, whereas non-CardioMEMS patients (n=12) showed a decrease in GFR from 23.33 to 21.17 over the same time period.
- Conclusion –
- In this two-year cohort analysis of HF patients with CKD Stage 3 and 4, CardioMEMS was associated with statistically significant preservation or improvement in renal function. These findings suggest the potential value of Pulmonary Artery Pressure-guided management of heart failure in high-risk populations to slow the rate of renal decline via improved hemodynamic monitoring and proactive management. Future studies involving larger patient populations in additional centers will be valuable to further evaluate these findings and to explore optimal management strategies for heart failure patients with chronic kidney disease.