@article{3111478,
    title = "Early drop in systolic blood pressure and worsening renal function in acute heart failure: Renal results of Pre-RELAX-AHF",
    author = "Voors, A.A. and Davison, B.A. and Felker, G.M. and Ponikowski, P. and Unemori, E. and Cotter, G. and Teerlink, J.R. and Greenberg, B.H. and Filippatos, G. and Teichman, S.L. and Metra, M. and Teichman, S.L. and Massie, B.M. and Goldstein, S. and Bohm, M. and Francis, G. and Davis, C.E. and Boldueva, S. and Moiseev, V. and Shogenov, Z. and Ruda, M. and Vishnevsky, A. and Boyarkin, M. and Simanenkov, V. and Tereschenko, S. and Shwartz, Y. and Orlikova, O. and Arkhipov, M. and Libov, I. and Sardinov, R. and Suvorov, A. and Marmor, A. and Katz, A. and Zimlichman, R. and Omary, M. and Hershkoviz, R. and Goland, S. and Keren, A. and Aronson, D. and Grzybowski, J. and Musial, W. and Apró, D. and Lupkovics, G. and Stamate, C. and Salajan, A. and Matei, A. and Levy, P. and Pang, P. and Collins, S. and Gupta, D. and Van Mieghem, W. and Muyldermans, L. and Vervoort, G.",
    journal = "European Journal of Heart Failure",
    year = "2011",
    volume = "13",
    number = "9",
    pages = "961-967",
    publisher = "John Wiley and Sons Ltd",
    doi = "10.1093/eurjhf/hfr060",
    keywords = "angiotensin receptor antagonist;  beta adrenergic receptor blocking agent;  calcium channel blocking agent;  creatinine;  digoxin;  dipeptidyl carboxypeptidase inhibitor;  hydralazine;  placebo;  relaxin, acute heart failure;  aged;  article;  blood pressure regulation;  creatinine blood level;  female;  groups by age;  human;  kidney dysfunction;  major clinical study;  male;  mortality;  multicenter study (topic);  outcome assessment;  pathophysiology;  post hoc analysis;  predictor variable;  prevalence;  priority journal;  randomized controlled trial (topic);  risk assessment;  systolic blood pressure",
    abstract = "Aims We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and resultsThe Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) for AHF and randomized them to relaxin given intravenous (i.v.) for 48 h or placebo. Blood pressure was measured at baseline, at 3, 6, 9, 12, 24, 36, and 48 h and at 3, 4, and 5 days after enrolment. Worsening renal function was defined as a serum creatinine increase of <0.3 mg/dL by Day 5. Worsening renal function was found in 68 of the 225 evaluable patients (30). Patients with WRF were older (73.5 ± 9.4 vs. 69.1 ± 10.6 years; P 0.003), had a higher baseline SBP (147.3 ± 19.9 vs. 140.8 ± 16.7 mmHg; P 0.01), and had a greater early drop in SBP (37.9 ± 16.0 vs. 31.4 ± 12.2 mmHg; P 0.004). In a multivariable model, higher age, higher baseline creatinine, and a greater early drop in SBP, but not baseline SBP, remained independent predictors of WRF. Furthermore, WRF was associated with a higher Day 60 (P 0.01), and Day 180 (P 0.003) mortality. ConclusionsWorsening renal function in hospitalized AHF patients is related to a poor clinical outcome and is predicted by a greater early drop in SBP. © 2011 The Author."
}