Abstract 13105: Acute Cardiorenal Syndrome: The Prevalence of Impaired, Improved and Stable Renal Function in Patients With Acute Heart Failure
Bibliographic record
Abstract
Introduction: Acute heart failure (AHF) is frequently accompanied by worsening renal function (WRF) and this has been linked to poor outcomes. However, prior studies have not accounted for the changes in renal function relative to baseline renal function, or the outcomes of patients with improved renal function (RF). We investigated the prevalence of WRF and improved RF in patients admitted with AHF. Methods: We included 276 AHF patients enrolled at the University of Alberta Hospital into the AHF-EM study. Definitions from the Kidney Disease Outcomes Quality Initiative (K/DOQI) stages (1-5 stages) were used using eGFR (MDRD) from baseline and discharge. WRF was defined as worsening from stage 1, 2, 3a at admission to 3B or worse, from 3B to worse, or from 4 to 5. Improved RF was defined as improvement of at least one class from 3B, 4 or 5. Stable RF was defined as renal function within the same K/DOQI stage in stages 3A, 3B, 4, or 5. Results: Patients were a mean age of 76 years, 50% were male, 34% had diabetes and the mean ejection fraction was 41%. The prevalence of WRF was 13%, Improved RF 10% and stable RF 31%. Improved RF patients were found to have the lowest in-hospital mortality rates (0%), compared to Stable RF (7%) and WRF patients (16%) (p=0.016). Patterns of medication use, medical history or admission parameters such as blood pressure, hydration status, and blood serum electrolytes were not significantly different among groups. Conclusion: When patients with an eGFR 2 are considered, the prevalence of WRF is lower than previously estimated, and interestingly a similar number of patients show improvement of RF. Improvement of RF upon treatment of AHF likely indicates ‘genuine’ acute cardiorenal syndrome, while those with WRF may be ‘treatment associated’ acute cardiorenal syndrome. The latter may reflect more severe underlying pathophysiological picture that leads to poor outcomes. (the study was funded by the Canadian Institute for Health Research)
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".