Ultrasound Assessment of Kidney Volume in Patients with Acute Decompensated Heart Failure: A Predictor of Diuretic Resistance Ultrasound Assessment of diuretic resistance

Shinobu Sugihara; Yoshiharu Kinugasa; Tomoaki Takata; Takaaki Sugihara; Keiko Hosho; Chitose Imai; Hiromi Ito; Kensaku Yamada; Masahiko Kato; Kazuhiro Yamamoto

doi:10.33160/yam.2017.09.001

Original Article

Ultrasound Assessment of Kidney Volume in Patients with Acute Decompensated Heart Failure: A Predictor of Diuretic Resistance

Ultrasound Assessment of diuretic resistance

Shinobu Sugihara , Yoshiharu Kinugasa, Tomoaki Takata, Takaaki Sugihara, Keiko Hosho, Chitose Imai, Hiromi Ito, Kensaku Yamada, Masahiko Kato, Kazuhiro Yamamoto

Author information

Shinobu Sugihara [Japan] Corresponding author
Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Yoshiharu Kinugasa [Japan]
Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Tomoaki Takata [Japan]
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Takaaki Sugihara [Japan]
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Keiko Hosho [Japan]
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Chitose Imai [Japan]
Division of Clinical Laboratory Med- icine, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Hiromi Ito [Japan]
Department of Clinical Radiology, Tottori University Hospital, Yonago 683-8504, Japan [Japan]
Kensaku Yamada [Japan]
Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Masahiko Kato [Japan]
Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]
Kazuhiro Yamamoto [Japan]
Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan [Japan]

Keywords: acute decompensated heart failure, diuretic resistance, kidney volume, ultrasound examination

JOURNAL OPEN ACCESS

2017 Volume 60 Issue 3 Pages 135-144

DOI https://doi.org/10.33160/yam.2017.09.001

Details

Abstract

Background Diuretics are essential for treating acute decompensated heart failure (ADHF), but the response is inconsistent. This study aimed to clarify whether kidney volume as assessed by ultrasound (US) predicts diuretic resistance in patients with ADHF.
Methods We enrolled 29 patients with ADHF and 32 controls. Height-adjusted kidney volume was assessed by US. We divided patients into two groups based on the median value of total daily use of furosemide (intravenous dose plus 0.5 × oral dose of furosemide equivalents) during 3 days from admission.
Results Patients with ADHF had a significantly smaller left kidney volume than did control subjects (27.7 ± 10.0 vs. 32.8 ± 8.8 mL/m, P < 0.05). Patients in the high-dose furosemide group (≥ 51.7 mg/d) had a significantly lower estimated glomerular filtration rate (eGFR) and a significantly smaller kidney volume than did those in the low-dose furosemide group (eGFR: 43.9 ± 20.4 vs. 60.8 ± 21.6 mL/min/1.73 m², left kidney volume: 23.2 ± 5.2 vs. 32.6 ± 11.0 mL/m, right kidney volume: 26.5 ± 7.5 vs. 32.6 ± 7.9 mL/m, all P < 0.05). Multivariate logistic analysis showed that left kidney volume, but not eGFR, was independently associated with the requirement of high-dose furosemide (odds ratio: 0.856, 95% confidence interval: 0.735–0.997, P < 0.05).
Conclusion Kidney volume as assessed by US is a useful predictor of diuretic resistance in patients with ADHF.

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