European journal of internal medicine
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Eur. J. Intern. Med. · Feb 2025
Multicenter StudyDifferent impact of chronic kidney disease in older patients with heart failure according to frailty.
Chronic kidney disease (CKD) and frailty are often present in older patients with heart failure (HF). Our aim was to evaluate the association of CKD and frailty in one-year mortality in a cohort of older (≥75 years) outpatients with HF METHODS: Our data come from the FRAGIC study ("impacto de la FRAGilidad y otros síndromes Geriátricos en el manejo clínico y pronóstico del paciente anciano ambulatorio con Insuficiencia Cardíaca"), a multicenter prospective registry conducted in 16 cardiology services in Spain which included ≥75 years outpatients with HF. Renal function was assessed according to CKD-EPI formula. A comprehensive geriatric assessment was performed and frailty was identified according to visual mobility scale (frail if VMS≥2). Survival rates were analyzed by Cox regression model. ⋯ Most HF patients≥75 years have renal dysfunction. CKD is a marker of worse prognosis in elderly patients with chronic HF, but it does not independently associate one-year mortality in the presence of frailty.
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Eur. J. Intern. Med. · Feb 2025
Multicenter StudyHyperchloremic metabolic acidosis potentially benefiting sodium bicarbonate therapy: A multi-center cohort study.
The use of sodium bicarbonate for metabolic acidosis has been a topic of debate, primarily due to the lack of clinical efficacy evidence. This study aims to identify which types of patients with various acid-base balance parameters can benefit from sodium bicarbonate therapy. ⋯ This study identified an interaction between baseline chloride and sodium bicarbonate therapy on patient survival. Hyperchloremic metabolic acidosis may potentially benefit from sodium bicarbonate therapy. Further prospective randomized controlled studies are warranted.