# Nierfunctietrajecten vóór en na hospitalisatie voor HFrEF

*geplaatst 2025-11-14 · Hartfalen · European heart journal · doi 10.1093/eurheartj/ehaf457 · https://hartvaat.nl/2025/11/14/nierfunctietrajecten-voor-en-na-hospitalisatie-voor-hfref/*

Studie documenteerde nierfunctietrajecten rond HFrEF-hospitalisatie. Verschillende trajectpatronen zijn geassocieerd met verschillende prognoses, wat gepersonaliseerde nefrologische zorg informeert.

## English: Kidney function trajectories before and after hospitalization for heart failure with reduced ejection fraction.

Using individual patient data from clinical trials and a real-world cohort, this study characterised kidney function trajectories before and after heart failure hospitalisation in HFrEF. Distinct trajectory patterns carried different prognostic implications, informing personalised nephrological management.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: Worsening kidney function is a key prognostic factor in heart failure (HF) with reduced ejection fraction (HFrEF). However, associations between kidney function trajectories and HF-related events remain unclear. METHODS: Longitudinal changes in estimated glomerular filtration rate (eGFR) before and after a HF-related event, defined as HF hospitalization or HF death, were examined using individual patient data from two clinical trials (EPHESUS and EMPHASIS-HF) and a real-world cohort (BARCELONA). RESULTS: HF-related events occurred in 14.1% of 8587 patients [EPHESUS/EMPHASIS-HF; median follow-up 17.1 (12.4-22.7) months] and 33.8% of 2048 patients [BARCELONA; median 47.0 (18.8-90.6) months]. In EPHESUS and EMPHASIS-HF, patients who experienced an HF-related event had a steeper decline in eGFR in the year preceding the event (average -4.83 mL/min/1.73 m²/year) compared with those who did not have an HF-related event (-1.18 mL/min/1.73 m²/year). Over the 1 year following an HF-related event, eGFR continued to decline, though at a slower rate (average -3.45 mL/min/1.73 m²/year). Similar kidney function trajectories were observed in BARCELONA (average eGFR decline -1.35 mL/min/1.73 m²/year in patients without HF event vs -5.77 mL/min/1.73 m²/year 1 year before an event and -3.04 mL/min/1.73 m²/year over the year after an event). Worsening New York Heart Association class paralleled steeper eGFR decline prior to HF events. CONCLUSIONS: In HFrEF, kidney function decline may precede a HF hospitalization or death by up to 1 year, linking to symptomatic congestion. Monitoring eGFR slopes rather than relying solely on specific cut-off values may allow early detection of at-risk patients.

Auteurs: Masatake Kobayashi, Antoni Bayes-Genis, Kevin Duarte, John J V McMurray, João Pedro Ferreira, Stuart J Pocock, Dirk J Van Veldhuisen, Josep Lupón, Bertram Pitt, Faiez Zannad, Nicolas Girerd

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehaf457. Bijgewerkt 2026-07-03T13:30:58Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.