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Blood Urea Nitrogen Helps Predict Heart Failure Mortality

Blood urea nitrogen may have better prognostic value than creatinine-based measurements

TUESDAY, June 10 (HealthDay News) -- Blood urea nitrogen may be a better predictor of mortality than glomerular filtration rate in patients with stage B and C heart failure, according to research published in the June 1 issue of the American Journal of Cardiology.

Clay A. Cauthen, M.D., of the University of Virginia Health System in Charlottesville, Va., and colleagues analyzed data in a retrospective study from 444 patients with stage B or C heart failure. Patients had a mean age of 59, and average follow-up was 7.5 years, during which time 33 percent of patients died.

Patients with increased blood urea nitrogen and decreased glomerular filtration rate (GFR) had increased long-term mortality, with respective eight-year mortalities of 57 and 55 percent, the researchers report. Further analysis showed that blood urea nitrogen and stage C heart failure were independently associated with greater mortality, but GFR was not, they note.

"In patients with heart failure, increases in blood urea nitrogen may reflect not only decreased GFR but also aberrations in fluid volume balance, neurohormonal activities and hemodynamics. In advanced heart failure, the more frequent use of high-dose diuretics and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy may potentially contribute to increases in blood urea nitrogen. Muscle wasting and cachexia in patients with advanced heart failure may also increase blood urea nitrogen," the authors write. "Thus, blood urea nitrogen may serve as a more encompassing biomarker by reflecting the interplay between cardiovascular and renal dysfunctions, serving as a potential surrogate for the increasing use of drugs that affect renal function, and for systemic wasting as a result of advancing heart failure."

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