因急性心力衰竭入院的患者中，哪些心力衰竭治疗与肾功能恶化有关？
Any heart failure treatments associated with worsening renal function in patients admitted due to acute heart failure?
机构信息
Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand.
Department of Nursing, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand.
出版信息
Ren Fail. 2021 Dec;43(1):123-127. doi: 10.1080/0886022X.2020.1858100.
BACKGROUND
Worsening renal function (WRF) occurs in approximately 25% of acute heart failure patients, and both baseline characteristics and heart failure treatment may increase the risk of WRF. This study aimed to evaluate additional risk factors for WRF in acute heart failure, particularly those related to heart failure treatment.
METHODS
This was a retrospective, observational, analytical study. The inclusion criteria were age 18 years or over, hospital admission due to acute heart failure, and having undergone at least two serum creatinine tests during admission. The eligible patients were classified into two groups: WRF and non-WRF. Predictors for WRF (including treatment parameters) were determined using logistic regression analysis.
RESULTS
During the study period, there were 301 eligible patients who met the study criteria. Of those, 82 (27.24%) had WRF. There were two independent factors associated with WRF occurrence: baseline diastolic blood pressure and beta blocker treatment, with adjusted odds ratios (95% confidence interval) of 1.060 (1.008, 1.114) and 0.064 (0.006, 0.634), respectively. The Hosmer-Lemeshow Chi square for the final model was 6.11 ( = .634).
CONCLUSIONS
After examining several heart failure treatments and baseline factors, we found that beta blocker treatment results improvement in kidney function.
背景
约 25%的急性心力衰竭患者会出现肾功能恶化（WRF），基线特征和心力衰竭治疗均可能增加 WRF 的风险。本研究旨在评估急性心力衰竭中 WRF 的其他危险因素，特别是与心力衰竭治疗相关的危险因素。
方法
这是一项回顾性、观察性、分析性研究。纳入标准为年龄≥18 岁、因急性心力衰竭住院、入院期间至少进行了两次血清肌酐检查。符合条件的患者被分为 WRF 组和非 WRF 组。使用逻辑回归分析确定 WRF 的预测因素（包括治疗参数）。
结果
在研究期间，有 301 名符合研究标准的合格患者。其中，82 名（27.24%）发生了 WRF。有两个独立的因素与 WRF 的发生相关：基线舒张压和β受体阻滞剂治疗，调整后的比值比（95%置信区间）分别为 1.060（1.008，1.114）和 0.064（0.006，0.634）。最终模型的 Hosmer-Lemeshow χ 平方值为 6.11（ =.634）。
结论
在检查了几种心力衰竭治疗和基线因素后，我们发现β受体阻滞剂治疗可改善肾功能。
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