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- W1973994872 abstract "Background: Serum blood urea nitrogen (BUN) has been considered as the single most important prognostic marker in patients admitted to hospital with decompensated heart failure, and is commonly used to assess adequate dialysis in nephrology. However, its ability to provide incremental information in serial measures in the ambulatory setting has not been carefully studied. Methods: We identified 2,292 consecutive ambulatory patients with documented chronic systolic HF (left ventricular ejection fraction [LVEF] <50%) with serial serum BUN and creatinine (Cr) measurements, and evaluated the impact of these changes from baseline to 6-24 months on subsequent long-term outcome. Results: In our study cohort (mean age 65 ± 14 years, 71% male, mean LVEF 25 ± 10%), the median BUN was 21 mg/dL (IQR 16-29; 28% had BUN>25 mg/dL or “High”) mg/dL and the mean Cr was 1.1 ± 0.4 mg/dL. 70% of those with elevated baseline BUN had persistent elevation (High→High) and had 74% increased adjusted mortality risk over those with normal baseline and follow-up BUN (Low→Low). In contrast, 21% experienced worsening from baseline normal BUN (Low→High) still demonstrated higher mortality risk than those improved from high BUN (High→Low). These findings were similar when analyzed within those with estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2 or with Cr <1.2 mg/dL. Conclusion: In ambulatory patients with chronic systolic heart failure, rise in serum BUN over time portends poor long-term prognosis, even when adjusted for eGFR." @default.
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- W1973994872 date "2010-08-01" @default.
- W1973994872 modified "2023-10-14" @default.
- W1973994872 title "Prognostic Importance of Serial Evaluation of Blood Urea Nitrogen in Ambulatory Patients With Chronic Systolic Heart Failure" @default.
- W1973994872 doi "https://doi.org/10.1016/j.cardfail.2010.06.288" @default.
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