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Relationship between blood urea nitrogen-to-creatinine ratio at hospital admission and long-term mortality in patients with acute decompensated heart failure

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Abstract

Although elevated blood urea nitrogen (BUN)-to-creatinine (BUN/Cr) ratio at hospital admission has been reported to be associated with poor short-term prognosis, its association to long-term mortality in patients with acute decompensated heart failure (ADHF) remains to be elucidated. Moreover, an additive prognostic value to preexisting renal markers including creatinine and BUN has not been well described. A cohort of 557 consecutive ADHF patients admitted to the cardiac intensive care unit was studied. All cohorts were divided into high and low BUN/Cr ratios according to the median value of BUN/Cr ratio at admission. Association between admission BUN/Cr ratio and long-term all-cause mortality was assessed. There were 145 deaths (27%) observed during the follow-up period of 1.9 years in median. Patients with high BUN/Cr ratio showed with higher mortality compared to low BUN/Cr ratio (log-rank: P = 0.006). In the multivariable analysis, patients with high BUN/Cr ratio at admission were associated with high mortality independently from other covariates including BUN and creatinine (HR 1.81, 95% CI 1.16–2.80, P = 0.009). In patients with ADHF, there is a relationship between admission BUN-to-creatinine ratio and long-term mortality.

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Funding

This study is partly supported by a Grant-in-Aid for Scientific Research (C) [Grant Number 26507010], and a grant to the Respiratory Failure Research Group from the Ministry of Health, Labor and Welfare, Japan. These funding sources do not have any other roles in this study.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Azusa Murata, Takatoshi Kasai, Yuya Matsue, Hiroki Matsumoto, Shoichiro Yatsu, Takao Kato, Shoko Suda, Masaru Hiki, Atsutoshi Takagi & Hiroyuki Daida

  2. Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Takatoshi Kasai, Hiroki Matsumoto & Shoko Suda

  3. Department of Cardiology, Kameda Medical Center, Chiba, Japan

    Yuya Matsue

Authors
  1. Azusa Murata
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  2. Takatoshi Kasai
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  3. Yuya Matsue
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  4. Hiroki Matsumoto
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  5. Shoichiro Yatsu
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  6. Takao Kato
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  7. Shoko Suda
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  8. Masaru Hiki
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  9. Atsutoshi Takagi
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  10. Hiroyuki Daida
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Corresponding author

Correspondence to Takatoshi Kasai.

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Conflict of interest

Dr. Takatoshi Kasai has received unrestricted research funding from Philips Respironics, Fukuda Denshi, ResMed, and Teijin Home Healthcare. Dr. Yuya Matsue is supported by JSPS (Japan Society for the Promotion of Science) Postdoctoral Fellowships for Research Abroad, and received a honorarium from Otsuka Pharmaceutical Co. Dr. Hiroyuki Daida received research grant from various pharmaceutical companies and payment for lectures including service in speakers’ bureaus from Medtronic Japan, AstraZeneca K.K., MSD K.K., Ono Pharmaceutical Co. Ltd, Glaxosmithkline K.K., Shionogi and Co. Ltd, Daiichi Sankyo Company, Takeda Pharmaceutical Co. Ltd, Nippon Boehringer Ingelheim Co. Ltd, Bayer Yakuhin, Ltd, Terumo Corporation, Astellas Pharma Inc. The other authors report no conflicts of interest.

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Murata, A., Kasai, T., Matsue, Y. et al. Relationship between blood urea nitrogen-to-creatinine ratio at hospital admission and long-term mortality in patients with acute decompensated heart failure. Heart Vessels 33, 877–885 (2018). https://doi.org/10.1007/s00380-018-1135-3

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  • DOI: https://doi.org/10.1007/s00380-018-1135-3

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