%0 Journal Article
%T Predictors of developing renal dysfunction following diagnosis of transthyretin cardiac amyloidosis.
%A McDonald ML
%A Manla Y
%A Sonnino A
%A Alonso M
%A Neicheril RK
%A Sanchez A
%A Lafave G
%A Armas YS
%A Camargo AL
%A Uppal D
%A Handa A
%A Wolinsky D
%A Rivera NT
%A Velez M
%A Baran DA
%A Estep JD
%A Snipelisky D
%J Clin Cardiol
%V 47
%N 6
%D 2024 Jun
%M 38873847
%F 3.287
%R 10.1002/clc.24298
%X <B>BACKGROUND: </B>In patients with transthyretin cardiac amyloidosis (ATTR-CA), renal dysfunction is a poor prognostic indicator. Limited data are available on variables that portend worsening renal function (wRF) among ATTR-CA patients.<BR><B>OBJECTIVE: </B>This study assesses which characteristics place patients at higher risk for the development of wRF (defined as a drop of ≥10% in glomerular filtration rate [GFR]) within the first year following diagnosis of ATTR-CA.<BR><B>METHODS: </B>We included patients with ATTR-CA (n = 134) evaluated between 2/2016 and 12/2022 and followed for up to 1 year at our amyloid clinic. Patients were stratified into two groups: a group with maintained renal function (mRF) and a group with wRF and compared using appropriate testing. Significant variables in the univariate analysis were included in the multivariable logistic regression model to determine characteristics associated with wRF.<BR><B>RESULTS: </B>Within a follow-up period of 326 ± 118 days, the median GFR% change measured -6% [-18%, +8]. About 41.8% (n = 56) had wRF, while the remainder had mRF. In addition, in patients with no prior history of chronic kidney disease (CKD), 25.5% developed de novo CKD. On multivariable logistic regression, only New York Heart Association (NYHA) class ≥III (odds ratio [OR]: 3.9, 95% confidence interval [CI]: [1.6-9.3]), history of ischemic heart disease (IHD) (OR: 0.3, 95% CI: [0.1-0.7]), and not receiving SGLT-2i (OR: 0.1, 95% CI: [0.02-0.5]) were significant predictors of wRF.<BR><B>CONCLUSIONS: </B>Our study demonstrated that the development of de novo renal dysfunction or wRF is common following the diagnosis of ATTR-CA. Additionally, we identified worse NYHA class and no prior history of IHD as significant predictors associated with developing wRF, while receiving SGLT-2i therapy appeared to be protective in this population.