The association of beta-blocker use with mortality in elderly patients with congestive heart failure and advanced chronic kidney disease
Open Access
- 8 September 2019
- journal article
- research article
- Published by Oxford University Press (OUP) in Nephrology Dialysis Transplantation
- Vol. 35 (5), 782-789
- https://doi.org/10.1093/ndt/gfz167
Abstract
Whether the survival benefit of β-blockers in congestive heart failure (CHF) from randomized trials extends to patients with advanced chronic kidney disease (CKD) [estimated glomerular filtration rate (eGFR) 60, 30–60, 60, n = 3136; eGFR 30–60, n = 2368; eGFR 60: adjusted HR 0.55, 95% CI 0.49–0.62; 30–60: adjusted HR 0.63, 95% CI 0.55–0.71; <30: adjusted HR 0.55, 95% CI 0.41–0.73; interaction term, P = 0.30). The results were consistent in an intention-to-treat analysis and with β-blocker use treated as a time-varying exposure. β-Blocker use is associated with reduced all-cause mortality in elderly patients with CHF and CKD, including those with an eGFR <30. Randomized trials that examine β-blockers in patients with CHF and advanced CKD are needed.Funding Information
- Institute for Clinical Evaluative Sciences
- ICES
- Ontario Ministry of Health and Long-Term Care
- MOHLTC
- Academic Medical Organization of Southwestern Ontario
- AMOSO
- Schulich School of Medicine and Dentistry
- SSMD
- Western University and the Lawson Health Research Institute
- LHRI
- Canadian Institutes of Health Research
- CIHR
- KRESCENT Foundation
- McMaster Department of Medicine
- Kidney Foundation of Canada
- St Joseph’s Research Institute Hamilton
- Jindal Research Chair
- Prevention of Kidney Disease
- Dr Adam Linton Chair in Kidney Health Analytics
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