Evidence map›Paper›PMID 39918536›Full record

ArticleJACC. Heart failure2025

Outcomes of KDIGO-Defined CKD in U.S. Veterans With HFpEF, HFmrEF, and HFrEF.

Samir Patel, Venkatesh K Raman, Charles Faselis, Gregg C Fonarow, Phillip H Lam, Amiya A Ahmed, Paul A Heidenreich, Stefan D Anker, Prakash Deedwania, Charity J Morgan and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Kidney Failure in Cardiogenic Shock.Circulation. Heart failure · 2026
    Review
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Review
  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Samir PatelDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.
Venkatesh K RamanDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA.
Charles FaselisDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, Uniformed Services University, Washington, District of Columbia, USA.
Gregg C FonarowDepartment of Medicine, University of California, Los Angeles, California, USA. Electronic address: https://twitter.com/gcfmd.
Phillip H LamDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA; Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia, USA. Electronic address: https://twitter.com/PhilLamMD.
Amiya A AhmedDepartment of Medicine, Yale University, New Haven, Connecticut, USA.
Paul A HeidenreichDepartment of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA; Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Stefan D AnkerDepartment of Cardiology of German Heart Center Charité; German Centre for Cardiovascular Research partner site Berlin, Charité Universitätsmedizin, Berlin, Germany; Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Prakash DeedwaniaDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, University of California, San Francisco, California, USA.
Charity J MorganDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Sijian ZhangDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.
Hans MooreDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA; Department of Medicine, Uniformed Services University, Washington, District of Columbia, USA.
Janani RangaswamiDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA. Electronic address: https://twitter.com/RangaswJ.
George BakrisDepartment of Medicine, University of Chicago, Chicago, Illinois, USA.
Javed ButlerBaylor Scott and White Research Institute, Dallas, Texas, USA; Department of Medicine, University of Mississippi, Jackson, Mississippi, USA. Electronic address: https://twitter.com/JavedButler1.
Helen M SheriffDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.
Richard M AllmanDepartment of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
Qing Zeng-TreitlerDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA.
Wen-Chih WuDepartment of Medicine, Veterans Affairs Medical Center, Providence, Rhode Island, USA; Department of Medicine, Brown University, Providence, Rhode Island, USA.
Ali AhmedDepartment of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia, USA; Department of Medicine, George Washington University, Washington, District of Columbia, USA; Department of Medicine, Georgetown University, Washington, District of Columbia, USA. Electronic address: ali.ahmed@va.gov.

Funding

HSRD VA I01 HX002422HSRD VA SDR 02-237
6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) is defined by the KDIGO (Kidney Disease: Improving Global Outcomes) guideline as abnormal kidney structure or function, present for >3 months, with implications for health. KDIGO-defined CKD is associated with poor outcomes in patients with heart failure (HF). Less is known about whether these associations vary by left ventricular ejection fraction.

objectivesThis study aims to determine the prevalence and outcomes of KDIGO-defined CKD in heart failure with preserved ejection fraction (HFpEF), heart failure with mildly reduced ejection fraction (HFmrEF), and heart failure with reduced ejection fraction (HFrEF).

methodsOf the 1,446,053 veterans with an HF diagnosis (1991-2017) in the national Veterans Affairs electronic health record data, 365,000 with data on EF had KDIGO-defined CKD or normal kidney function (NKF). CKD was defined as 2 values measured 90 days apart of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m

resultsAmong patients with HF and NKF, mortality occurred in 39%, 37%. and 41%, and HF hospitalization occurred in 12%, 15%, and 21% of those with HFpEF, HFmrEF. and HFrEF, respectively. Compared with NKF, CKD was associated with 16%, 19%, and 26% higher multivariable-adjusted risks for death in patients with HFpEF, HFmrEF, and HFrEF, respectively. Respective risks for HF hospitalization were 31%, 33%, and 32% higher. The eGFR-associated risks were incrementally higher with decreasing eGFR, except for eGFR <15 mL/min/1.73 m

conclusionsThese findings based on KDIGO-defined CKD and NKF provide new information about the best estimates of true prevalence and outcomes of CKD in HFpEF, HFmrEF, and HFrEF.

Indexed as

Heart FailureRenal Insufficiency, ChronicStroke VolumeVeteransAgedFemaleGlomerular Filtration RateHospitalizationHumansMaleMiddle AgedPrevalenceRetrospective StudiesUnited StatesVentricular Function, Leftchronic kidney diseaseejection fractionheart failureKDIGO (Kidney Disease: Improving Global Outcomes)outcomes

Identifiers

PMID39918536
PMCPMC12844147

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.