Heartbeat:Blood urea nitrogen to creatinine ratio predicts outcome in acute heart failure

Otto, Catherine M.

doi:10.1136/heartjnl-2017-311339

Cited by 13 publications

(16 citation statements)

References 6 publications

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“…Coronavirus can affect kidney function by entering kidney cells in a direct ACE2‐dependent way 30 and activating the renin‐angiotensin‐aldosterone system (RAAS) with the systemic effects it generates. The RAAS increases the absorption of water and sodium in the kidney tubules, causing passive reabsorption of BUN 11‐25 . These systemic effects cause renal vasoconstriction, and accordingly, glomerular filtration and BUN excretion are reduced 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies show that the affected neurohormonal system is responsible for the reabsorption process in patients with acute heart failure (AHF) 9 . Other studies have similarly demonstrated that the BUN/Cr ratio is more valuable than BUN or Cr alone in predicting the progression of patients with AHF 11‐13 . We believe that multisystem inflammation, including a cytokine storm, can occur in severe and critical groups of COVID‐19 patients; this can in turn increase BUN reabsorption and the BUN/Cr ratio by similar mechanisms.…”

Section: Introductionmentioning

confidence: 91%

“…The RAAS increases the absorption of water and sodium in the kidney tubules, causing passive reabsorption of BUN. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] These systemic effects cause renal vasoconstriction, and accordingly, glomerular filtration and BUN excretion are reduced. 25 Notwithstanding, the BUN/Cr ratio increases as Cr is filtered through the glomeruli and not reabsorbed.…”

Section: Analysis Of Bun/cr Ratio and Nlr For Predicting Survival Omentioning

confidence: 99%

“…9 Other studies have similarly demonstrated that the BUN/Cr ratio is more valuable than BUN or Cr alone in predicting the progression of patients with AHF. [11][12][13] We believe that multisystem inflammation, including a cytokine storm, can occur in severe and critical groups of COVID-19 patients; this can in turn increase BUN reabsorption and the BUN/Cr ratio by similar mechanisms. As such, this ratio would be beneficial in assessing the severity and survival of those with COVID-19 disease.…”

Section: Introductionmentioning

confidence: 99%

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Predictive values of blood urea nitrogen/creatinine ratio and other routine blood parameters on disease severity and survival of COVID‐19 patients

Erdoğan

Durmuş

et al. 2020

Journal of Medical Virology

118

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We aimed to examine independent predictive factors for the severity and survival of COVID‐19 disease, from routine blood parameters, especially the blood urea nitrogen (BUN)/creatinine (Cr) ratio. A total of 139 patients with COVID‐19 were investigated at Siirt State Hospital. According to the disease severity, the patients were categorized as three groups (moderate: 85, severe: 54, and critical: 20). Then, patients were divided into two groups: nonsevere (moderate) and severe (severe and critical). Demographic, clinical data, and routine blood parameters were analyzed. In multivariate model adjusted for potential confounders BUN/Cr ratio (odds ratio [OR] = 1.70; 95% confidence interval [CI]: 1.20‐2.40; P = .002) and neutrophil to lymphocyte ratio (NLR) (OR = 2.21; 95% CI: 1.20‐4.30; P < .001) were independent predictive factors for disease severity. In multivariate Cox proportional hazard model BUN/Cr ratio (hazard ratio [HR] = 1.02; 95% CI: 1.01‐1.05; P = .030), and NLR (HR = 1.17; 95% CI: 1.06‐1.30; P = .020) were independent predictors for survival of COVID‐19 disease. The optimal thresholds of the BUN/Cr ratio at 33.5 and 51.7 had the superior possibility for severe disease and mortality, area under the curve (AUC) were 0.98 and 0.95, respectively. The optimal thresholds of NLR at 3.27 and 5.72 had a superior possibility for severe disease and mortality, AUC were 0.87 and 0.85, respectively. BUN/Cr and NLR are independent predictors for COVID‐19 patient severity and survival. Routine evaluation of BUN/Cr and NLR can help identify high‐risk cases with COVID‐19.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Analysis Of Bun/cr Ratio and Nlr For Predicting Survival Omentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictive values of blood urea nitrogen/creatinine ratio and other routine blood parameters on disease severity and survival of COVID‐19 patients

Erdoğan

Durmuş

et al. 2020

Journal of Medical Virology

118

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“…[3] Some studies suggest that BUN/Cr, instead of a single BUN or Cr, is associated with the prognosis of patients with AHF. [4–6] Considering the many primary causes of AHF, AMI is one of them and is the current research focus. [7] The aim of this study was to investigate the correlation between BUN/Cr and the prognosis of patients with AMI complicated with AHF.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of blood urea nitrogen/creatinine ratio in the long-term prognosis of patients with acute myocardial infarction complicated with acute heart failure

2019

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At present, the long-term prognosis of patients with acute myocardial infarction (AMI) after emergency percutaneous coronary intervention is the focus of attention, and relevant research is actively investigating the risk factors associated with prognosis. Poor prognosis often exists in Patients with AMI complicated with acute heart failure (AHF). In recent years, some studies have found that blood urea nitrogen/creatinine ratio (BUN/Cr) can better predict the prognosis of patients with AHF than single BUN or Cr. The relationship between long-prognosis of patients with AMI, as one of the common causes of AHF, and BUN/Cr is unknown. The main purpose of this study was to determine whether BUN/Cr has a predictive value for long-term prognosis in patients with AMI complicated with AHF.In this study, 389 consecutive patients with AMI were enrolled. According to AHF and a median BUN/Cr at admission of 15.32, the patients were divided into four groups (non-AHF + low BUN/Cr, non-AHF + high BUN/Cr, AHF + low BUN/Cr, and AHF + high BUN/Cr groups). A 1-year follow-up was implemented, and the study endpoint was defined as all-cause mortality. Predictors associated with 1-year mortality were evaluated using the Cox proportional hazard analysis, and the Kaplan–Meier analysis was used to estimate the survival rates.AHF occurred in 163 patients (41.9%) during hospital admission and 29 patients died during the 1-year follow-up. The Cox proportional hazard analysis proved an association between the combination of AHF and high BUN/Cr and mortality; however, the association with AHF + low BUN/Cr was not statistically significant.AHF combined with elevated BUN/Cr is linked with an increased risk of mortality in patients with AMI, which suggests that BNU/Cr has a predictive value for prognosis in patients with AMI complicated with AHF.

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Clinical implications of admission and follow-up urea-to-creatinine ratio in patients with acute decompensated heart failure

Moubarez,

Fathelbab,

Mohammed

et al. 2024

Egypt. J. Critical. Care. Med.

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Purpose Acute decompensated heart failure (ADHF) patients with a poor renal function have a worse prognosis. The urea-to-creatinine ratio (UCR) may be a valuable tool for assessing kidney function and stratifying patients with ADHF. We evaluated the value of an admission and follow-up UCR in predicting AKI, 28-day mortality, and rehospitalization in patients with ADHF. Methods This prospective research comprised sixty patients with ADHF. Based on the mean admission UCR, patients are classified into two groups: the high UCR group (UCR ≥ 42.33) and the low UCR group (UCR < 42.33). On the third day, they are categorized into high UCR and low UCR groups according to the same mean of UCR (42.33). A 28-day follow-up was implemented. Results Thirty patients (50%) developed AKI, and nine (15%) died during follow-up. In the high UCR group, the development of AKI was considerably more significant than in the low UCR group on the 3rd day (69.2% vs. 35.2%, respectively, p = 0.010). Furthermore, the high UCR group experienced a higher death rate than the low UCR group on the 3rd day (26.9% vs. 5.8%, respectively, p = 0.024). A considerable statistical correlation was reported between UCR and eGFR on the 3rd day (p = 0.025). According to ROC, UCR on the 3rd day was a significant predictor of AKI and 28-day mortality in these patients ((AUC = 0.736 and 0.718, respectively). In contrast, UCR on admission was not a predictor of AKI or 28-day mortality (p = 0.578 and 0.305, respectively). Also, neither admission nor 3rd day UCR could predict HF readmission (p = 0.108 and 0.298, respectively). By the Kaplan–Meier curve, survival rates were highest when UCR ≤ 34.85 and reduced when UCR > 34.85 (p < 0.001). Conclusion The follow-up UCR is a good predictor of AKI development and elevated 28-day mortality in ADHF patients. Considering its simplicity, this biomarker should be used more systematically in clinical practice.

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Heartbeat:Blood urea nitrogen to creatinine ratio predicts outcome in acute heart failure

Cited by 13 publications

References 6 publications

Predictive values of blood urea nitrogen/creatinine ratio and other routine blood parameters on disease severity and survival of COVID‐19 patients

Predictive values of blood urea nitrogen/creatinine ratio and other routine blood parameters on disease severity and survival of COVID‐19 patients

Predictive value of blood urea nitrogen/creatinine ratio in the long-term prognosis of patients with acute myocardial infarction complicated with acute heart failure

Clinical implications of admission and follow-up urea-to-creatinine ratio in patients with acute decompensated heart failure

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