Evidence map›Paper›PMID 40189657›Full record

ArticleClinical and experimental nephrology2025

Fibrosis-4 index can predict improved renal function in acute heart failure with preserved ejection fraction.

Koken Irie, Yosuke Watanabe, Manabu Uematsu, Hiroshi Yokomichi, Yuma Ichikawa, Takeo Horikoshi, Toru Yoshizaki, Juntaro Deyama, Kenji Kuroki, Tsuyoshi Kobayashi and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and experimental nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

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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

1 citing paper in PubMed.

  1. Article
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

13 authors.

Koken IrieFaculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, Japan.
Yosuke WatanabeDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan. yosuke@yamanashi.ac.jp.
Manabu UematsuDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Hiroshi YokomichiDepartment of Epidemiology and Environmental Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, Japan.
Yuma IchikawaDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Takeo HorikoshiDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Toru YoshizakiDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Juntaro DeyamaDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Kenji KurokiDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Tsuyoshi KobayashiDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Takamitsu NakamuraDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Kazuto NakamuraDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
Akira SatoDepartment of Cardiology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImproved renal function (IRF) observed in acute heart failure (AHF) is associated with poor prognosis. Since IRF is linked to renal congestion resulting from inadequate decongestion, predicting IRF could enhance management strategies. The Fibrosis-4 (Fib-4) index, originally developed as a marker for liver fibrosis, correlates with hepatic congestion, which is associated with renal congestion, making it a potential predictor of IRF. This study aims to investigate whether the Fib-4 index can predict IRF in patients with AHF and preserved ejection fraction (AHFpEF).

methodsWe analyzed 389 patients hospitalized for AHF between April 2004 and March 2022 at Yamanashi University Hospital. All-cause mortality was monitored for 1 year. IRF was defined as a ≥ 20% increase in the estimated glomerular filtration rate (eGFR) compared to admission levels. Preserved ejection fraction was defined as an ejection fraction ≥ 40%.

resultsIRF was observed in approximately 21% of patients with AHFpEF. Kaplan-Meier analysis showed that patients with IRF had higher mortality rates than those without IRF (p = 0.03, log-rank test). Multivariable analysis for IRF revealed that the eGFR, albumin level, and a Fib-4 index ≥ 3.24 (determined by receiver-operating characteristic curve) on admission were independent predictors of IRF in patients with AHFpEF.

conclusionIRF in patients with AHFpEF is associated with poor prognosis. A higher Fib-4 index at admission in AHFpEF can serve as a predictor of IRF.

Indexed as

Glomerular Filtration RateHeart FailureKidneyStroke VolumeAcute DiseaseAgedAged, 80 and overBiomarkersFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesBiomarkersAcute heart failureFibrosis-4 indexHeart failure with preserved ejection fractionImproving renal function

Identifiers

PMID40189657
PMCPMC12441086

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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.