Baseline Albumin Is Associated with Worsening Renal Function in Patients with Acute Decompensated Heart Failure Receiving Continuous Infusion Loop Diuretics

Study Objectives To identify baseline predictors of worsening renal function (WRF) in an acute decompensated heart failure (ADHF) patient population receiving continuous infusion loop diuretics. Design Retrospective observational analysis. Setting Academic tertiary medical center. Patients A total of 177 patients with ADHF receiving continuous infusion loop diuretics from January 2006 through June 2009. Measurements and Main Results The mean patient age was 61years, 63% were male, similar to 45% were classified as New York Heart Association functional class III, and the median length of loop diuretic infusion was 4days. Forty-eight patients (27%) developed WRF, and 34 patients (19%) died during hospitalization. Cox regression time-to-event analysis was used to determine the time to WRF based on different demographic and clinical variables. Baseline serum albumin 3g/dl or less was the only significant predictor of WRF (hazard ratio [HR] 2.87, 95% confidence interval [CI] 1.60-5.16, p=0.0004), which remained significant despite adjustments for other covariates. Conclusion Serum albumin 3g/dl or less is a practical baseline characteristic associated with the development of WRF in patients with ADHF receiving continuous infusion loop diuretics.