2023
Improvement in Renal Function During the Treatment of Acute Decompensated Heart Failure: Relationship With Markers of Renal Tubular Injury and Prognostic Importance
Natov P, Ivey-Miranda J, Cox Z, Moreno-Villagomez J, Maulion C, Bellumkonda L, Shlipak M, Estrella M, Borlaug B, Rao V, Testani J. Improvement in Renal Function During the Treatment of Acute Decompensated Heart Failure: Relationship With Markers of Renal Tubular Injury and Prognostic Importance. Circulation Heart Failure 2023, 16: e009776. PMID: 36700431, PMCID: PMC10150783, DOI: 10.1161/circheartfailure.122.009776.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureStable renal functionGlomerular filtration rateRenal functionRenal tubular injuryHeart failureTubular injuryKIM-1Filtration rateRenal tubular injury markersTubular injury markersRenal function groupCumulative urine outputCardiorenal dysfunctionDiuretic dosesInjury markersWorse survivalWorsened survivalUrine outputDecongestive therapyPrognostic importanceAdverse outcomesLower admissionPatients
2021
Rates of Reversal of Volume Overload in Hospitalized Acute Heart Failure: Association With Long-term Kidney Function
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Rates of Reversal of Volume Overload in Hospitalized Acute Heart Failure: Association With Long-term Kidney Function. American Journal Of Kidney Diseases 2021, 80: 65-78. PMID: 34843844, PMCID: PMC9135960, DOI: 10.1053/j.ajkd.2021.09.026.Peer-Reviewed Original ResearchMeSH KeywordsBiomarkersGlomerular Filtration RateHeart FailureHumansKidneyNatriuretic Peptide, BrainRenal Insufficiency, ChronicRisk FactorsWater-Electrolyte ImbalanceConceptsB-type natriuretic peptideAcute heart failureEGFR declineHeart failureVolume overloadKidney functionNatriuretic peptideLower riskN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideHeart Failure Outcome StudyLong-term kidney functionG4-G5Adverse kidney outcomesClinical congestion scoreKidney function declineGlomerular filtration rateCause-specific hazards modelKidney outcomesTolvaptan (EVEREST) trialCardiovascular outcomesVasopressin AntagonismImproved survivalFunction declineDecreased riskRenal negative pressure treatment as a novel therapy for heart failure-induced renal dysfunction
Rao VS, Maulion C, Asher JL, Ivey-Miranda J, Cox ZL, Moreno-Villagomez J, Mahoney D, Turner JM, Wilson FP, Wilcox CS, Testani J. Renal negative pressure treatment as a novel therapy for heart failure-induced renal dysfunction. AJP Regulatory Integrative And Comparative Physiology 2021, 321: r588-r594. PMID: 34405731, DOI: 10.1152/ajpregu.00115.2021.Peer-Reviewed Original ResearchConceptsRenal plasma flowGlomerular filtration rateCongestive HFTubular pressureHeart failure hospitalizationPara-aminohippurate clearanceCentral venous pressureHigh fractional excretionNegative pressure therapyUrinary collecting systemNegative pressure treatmentSimilar diuresisFailure hospitalizationRenal dysfunctionCardiac tamponadeIothalamate clearanceFractional excretionRenal parametersKidney functionRenal congestionRenal responseRight kidneyVenous pressurePressure therapyControl kidneys
2020
Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients
Biegus J, Zymliński R, Testani J, Marciniak D, Zdanowicz A, Jankowska EA, Banasiak W, Ponikowski P. Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients. European Journal Of Heart Failure 2020, 23: 729-739. PMID: 33190378, DOI: 10.1002/ejhf.2053.Peer-Reviewed Original ResearchConceptsAcute heart failureGlomerular filtration rateHeart failureFiltration rateDay 1Acute heart failure patientsHospital heart failureSpot urine sodiumHeart failure patientsUrinary sodium concentrationAHF patientsInotrope useTherapeutic profilingUrine sodiumFailure patientsIndependent prognosticatorRenal functionDay 2PatientsEGFRConcomitant assessmentWater handlingSodium concentrationPrognosticatorExcretersCystatin C and Muscle Mass in Patients With Heart Failure
Ivey-Miranda JB, Inker LA, Griffin M, Rao V, Maulion C, Turner JM, Wilson FP, Tang WHW, Levey AS, Testani JM. Cystatin C and Muscle Mass in Patients With Heart Failure. Journal Of Cardiac Failure 2020, 27: 48-56. PMID: 32750487, PMCID: PMC8672303, DOI: 10.1016/j.cardfail.2020.07.013.Peer-Reviewed Original ResearchMeSH KeywordsCreatinineCystatin CGlomerular Filtration RateHeart FailureHumansMusclesRenal Insufficiency, ChronicConceptsHeart failureCreatinine clearanceMuscle massCystatin CHigher muscle massAssociation of eGFRcysGlomerular filtration rateLow muscle massCystatin C levelsAccurate GFR estimationMultivariable analysisFiltration rateEGFRcysEGFRcrBody compositionGFR estimationPatientsCreatinineC levelsClearanceMortalityAssociationAcute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure. JACC Heart Failure 2020, 8: 537-547. PMID: 32535124, PMCID: PMC9027677, DOI: 10.1016/j.jchf.2020.03.009.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute decompensated heart failureDecompensated heart failureHeart failureKidney functionAdverse outcomesAcute declineNT-proBNPComposite outcomeNatriuretic peptideHigh riskMultivariable Cox regression modelsTotal proteinAcute kidney functionMarkers of decongestionN-terminal prohormoneGlomerular filtration rateCox regression modelEGFR declineCardiovascular deathVolume overloadFiltration rateEGFRHospital changesDecongestionEvaluation of kidney function throughout the heart failure trajectory – a position statement from the Heart Failure Association of the European Society of Cardiology
Mullens W, Damman K, Testani JM, Martens P, Mueller C, Lassus J, Tang WHW, Skouri H, Verbrugge FH, Orso F, Hill L, Ural D, Lainscak M, Rossignol P, Metra M, Mebazaa A, Seferovic P, Ruschitzka F, Coats A. Evaluation of kidney function throughout the heart failure trajectory – a position statement from the Heart Failure Association of the European Society of Cardiology. European Journal Of Heart Failure 2020, 22: 584-603. PMID: 31908120, DOI: 10.1002/ejhf.1697.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsGlomerular filtration rateHeart failureKidney functionFiltration rateRenal functionSerum creatinineAcute heart failure episodeGuideline-directed medical therapyImproved long-term outcomesCardio-renal dysfunctionCardio-renal interactionsAcute heart failureChronic heart failureHeart Failure AssociationHeart failure careHeart failure stateHeart failure episodesAppropriate clinical contextLong-term outcomesRenal function assessmentFurther treatment strategiesNeurohumoral blockersLoop diureticsMedical therapyWorse outcomes
2019
Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction
Reddy YNV, Obokata M, Testani JM, Felker GM, Tang WHW, Abou-Ezzeddine OF, Sun JL, Chakrabothy H, McNulty S, Shah SJ, Lewis GD, Stevenson LW, Redfield MM, Borlaug BA. Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction. Journal Of Cardiac Failure 2019, 26: 101-107. PMID: 31618698, PMCID: PMC7036022, DOI: 10.1016/j.cardfail.2019.09.015.Peer-Reviewed Original ResearchConceptsRenal functionNonobese patientsHeart failureObese HFpEFObese patientsEjection fractionRenal responseAdverse renal responsesRight ventricular remodelingGlomerular filtration rateBody mass indexPlasma volume expansionSimilar weight lossCardiorenal hemodynamicsRenal dysfunctionPathophysiologic featuresMass indexAtrial fibrillationDecongestive therapyVentricular remodelingPericardial restraintFiltration rateHFpEFObese phenotypeSevere worseningChronic Heart Failure Is Infrequently Associated With Renal Dysfunction in Hypertrophic Cardiomyopathy
Rowin EJ, Romashko M, Testani JM, Koethe BC, Saxena D, Udelson JE, Maron BJ, Maron MS. Chronic Heart Failure Is Infrequently Associated With Renal Dysfunction in Hypertrophic Cardiomyopathy. Journal Of Cardiac Failure 2019, 25: 690-692. PMID: 31158468, DOI: 10.1016/j.cardfail.2019.05.012.Peer-Reviewed Original ResearchUrinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure
Martens P, Dupont M, Verbrugge FH, Damman K, Degryse N, Nijst P, Reynders C, Penders J, Tang WHW, Testani J, Mullens W. Urinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure. JACC Heart Failure 2019, 7: 404-414. PMID: 31047021, DOI: 10.1016/j.jchf.2019.02.011.Peer-Reviewed Original ResearchConceptsChronic HF patientsHF patientsHeart failureSodium excretionAcute decompensated heart failureAcute heart failure hospitalizationLongitudinal changesChronic heart failureDecompensated heart failureHeart failure hospitalizationHigher sodium excretionUrinary sodium concentrationGlomerular filtration rate measurementInterindividual differencesLarge interindividual differencesFiltration rate measurementAHF hospitalizationDyspnea scoreFailure hospitalizationNT-proBNPChronic heartEjection fractionIndependent predictorsClinical endpointsPathophysiologic interactions
2018
Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study
Lawson CA, Testani JM, Mamas M, Damman K, Jones PW, Teece L, Kadam UT. Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study. International Journal Of Cardiology 2018, 267: 120-127. PMID: 29957251, PMCID: PMC6024224, DOI: 10.1016/j.ijcard.2018.04.090.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseRenal functionKidney diseasePrevalence of CKDModerate chronic kidney diseaseSevere chronic kidney diseasePresence of diabetesAdjusted risk estimatesGlomerular filtration rateCase-control studyHeart failure monitoringUK national studyHF prognosisFirst hospitalisationHF patientsRenal declineHF cohortRelated comorbiditiesHF settingFiltration rateNatural courseHospitalisationHigh riskRisk associationCommunity populationWorsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury
Ahmad T, Jackson K, Rao VS, Tang WHW, Brisco-Bacik MA, Chen HH, Felker GM, Hernandez AF, O'Connor CM, Sabbisetti VS, Bonventre JV, Wilson FP, Coca SG, Testani JM. Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury. Circulation 2018, 137: 2016-2028. PMID: 29352071, PMCID: PMC6066176, DOI: 10.1161/circulationaha.117.030112.Peer-Reviewed Original ResearchMeSH KeywordsAcetylglucosaminidaseAcute DiseaseAcute Kidney InjuryAgedAged, 80 and overBiomarkersCreatinineCystatin CDiuresisFemaleGlomerular Filtration RateHeart FailureHepatitis A Virus Cellular Receptor 1HumansKidneyLipocalin-2MaleMiddle AgedSodium Potassium Chloride Symporter InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsKidney injury molecule-1Neutrophil gelatinase-associated lipocalinInjury molecule-1Acute heart failureGelatinase-associated lipocalinRenal tubular injuryTubular injury biomarkersAggressive diuresisROSE-AHF trialsTubular injuryInjury biomarkersRenal functionHeart failureMolecule-1D-glucosaminidaseHigh-dose loop diuretic therapyAcute heart failure treatmentKidney tubular injuryLoop diuretic therapyAcute kidney injuryGlomerular filtration rateHeart failure treatmentDiuretic therapyFurosemide equivalentsKidney injury
2017
Inflammation and cardio‐renal interactions in heart failure: a potential role for interleukin‐6
Hanberg JS, Rao VS, Ahmad T, Chunara Z, Mahoney D, Jackson K, Jacoby D, Chen M, Wilson FP, Tang WHW, Kakkar R, Testani JM. Inflammation and cardio‐renal interactions in heart failure: a potential role for interleukin‐6. European Journal Of Heart Failure 2017, 20: 933-934. PMID: 29024287, PMCID: PMC5895540, DOI: 10.1002/ejhf.963.Peer-Reviewed Original ResearchWorsening Renal Function and Mortality in Heart Failure
Testani JM, Brisco-Bacik MA. Worsening Renal Function and Mortality in Heart Failure. Circulation Heart Failure 2017, 10: e003835. PMID: 28209768, PMCID: PMC5382499, DOI: 10.1161/circheartfailure.117.003835.Commentaries, Editorials and LettersRenal tubular resistance is the primary driver for loop diuretic resistance in acute heart failure
Maaten J, Rao VS, Hanberg JS, Wilson F, Bellumkonda L, Assefa M, Broughton J, D'Ambrosi J, Tang W, Damman K, Voors AA, Ellison DH, Testani JM. Renal tubular resistance is the primary driver for loop diuretic resistance in acute heart failure. European Journal Of Heart Failure 2017, 19: 1014-1022. PMID: 28105769, PMCID: PMC6231236, DOI: 10.1002/ejhf.757.Peer-Reviewed Original ResearchConceptsAcute heart failureLoop diuretic resistanceRenal tubular responseDiuretic resistanceDiuretic responseRenal tubulesAHF patientsHeart failureLoop diureticsTubular responseRenal tubular resistanceBumetanide doseEffective decongestionIntravenous bumetanidePoor outcomeUrine collectionTubular resistanceSum of defectsPatient variabilityUrea clearancePatientsCommon barriersDoseClearanceDiuretics
2016
Relevance of Changes in Serum Creatinine During a Heart Failure Trial of Decongestive Strategies: Insights From the DOSE Trial
Brisco MA, Zile MR, Hanberg JS, Wilson FP, Parikh CR, Coca SG, Tang WH, Testani JM. Relevance of Changes in Serum Creatinine During a Heart Failure Trial of Decongestive Strategies: Insights From the DOSE Trial. Journal Of Cardiac Failure 2016, 22: 753-760. PMID: 27374839, PMCID: PMC5435117, DOI: 10.1016/j.cardfail.2016.06.423.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersCause of DeathCreatinineDisease ProgressionDisease-Free SurvivalDiureticsDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleFemaleFurosemideGlomerular Filtration RateHeart FailureHumansInfusions, IntravenousKidney Function TestsMaleMiddle AgedPrognosisSurvival RateTreatment OutcomeConceptsStable renal functionRenal functionComposite endpointDecongestive strategiesSerum creatinineDose trialAdverse outcomesClinical trialsSurrogate endpointsDiuretic Optimization Strategies Evaluation (DOSE) trialHeart failure clinical trialsHeart Failure TrialPoor prognostic signCoprimary endpointsComposite outcomeDecongestive therapyFailure TrialPrognostic signEmergency roomImproved outcomesLower riskCreatinineEndpointTrialsAbsence of riskReduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure
Hanberg JS, Sury K, Wilson FP, Brisco MA, Ahmad T, Maaten J, Broughton JS, Assefa M, Tang WH, Parikh CR, Testani JM. Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure. Journal Of The American College Of Cardiology 2016, 67: 2199-2208. PMID: 27173030, PMCID: PMC4867078, DOI: 10.1016/j.jacc.2016.02.058.Peer-Reviewed Original ResearchConceptsPulmonary artery catheterizationBlood urea nitrogenCardiac indexRenal functionHeart failureRenal dysfunctionGood renal functionReduced cardiac indexHigher cardiac indexGlomerular filtration rateSignificant inverse correlationMultiple subgroupsMulticenter populationWorse eGFRHF patientsCreatinine ratioArtery catheterizationPatient subgroupsFiltration rateSerial assessmentLinear mixed modelingESCAPE trialPatientsUrea nitrogenDysfunctionThe risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio
Brisco MA, Zile MR, Maaten J, Hanberg JS, Wilson FP, Parikh C, Testani JM. The risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio. International Journal Of Cardiology 2016, 215: 521-526. PMID: 27153048, PMCID: PMC4986924, DOI: 10.1016/j.ijcard.2016.04.100.Peer-Reviewed Original ResearchConceptsElevated blood urea nitrogenBUN/CrRenal dysfunctionBlood urea nitrogenCreatinine ratioUrea nitrogenLeft Ventricular Dysfunction (SOLVD) trialVentricular Dysfunction trialsGlomerular filtration rateRisk of deathBaseline characteristicsWorsened survivalAdverse eventsHeart failureTop tertileFiltration rateBottom tertileProteinuriaSurvival disadvantagePatientsMortalityTertileDysfunctionSurvivalSurvival models
2015
Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis
Schaub JA, Coca SG, Moledina DG, Gentry M, Testani JM, Parikh CR. Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis. JACC Heart Failure 2015, 3: 977-989. PMID: 26671676, PMCID: PMC4683413, DOI: 10.1016/j.jchf.2015.07.014.Peer-Reviewed Original ResearchMeSH KeywordsBiomarkersGlomerular Filtration RateHeart FailureHumansKidney Failure, ChronicNatriuretic Peptide, BrainPeptide FragmentsPredictive Value of TestsPrognosisConceptsAcute decompensated heart failureNT-proBNPRenal dysfunctionRenal functionHeart failureNatriuretic peptideDiagnosis of ADHFAmino-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptidePg/B-type natriuretic peptideAmino-Terminal ProElevated NT-proBNPHigher NT-proBNPDecompensated heart failurePooled risk ratioGlomerular filtration rateCoronary artery diseaseA Systematic ReviewADHF eventsArtery diseasePrognostic utilityWorse prognosisFiltration rateRisk ratioBlood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction
Parrinello G, Torres D, Testani JM, Almasio PL, Bellanca M, Pizzo G, Cuttitta F, Pinto A, Butler J, Paterna S. Blood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction. Internal And Emergency Medicine 2015, 10: 965-972. PMID: 26037394, DOI: 10.1007/s11739-015-1261-1.Peer-Reviewed Original ResearchConceptsBUN/CrInferior vena cavaRenal dysfunctionHeart failureVenous congestionBUN/Cr ratioMultiple logistic regression modelNYHA class 3Independent risk factorLong-term mortalityHeart failure patientsGlomerular filtration rateBlood urea nitrogenReceiver-operating characteristic analysisLogistic regression modelsCause deathHF outpatientsHF severityLower eGFRRenal functionAmbulatory visitsFailure patientsCreatinine ratioSingle centerRenal biomarkers