The mean deterioration in estimated GFR in patients with chronic heart failure was 1.5 mL min−1 1.73 m−2 in the first year, which can be considered to be moderate. A minority of patients (one sixth) experienced a strong decrease in renal function in the 1st year (15 mL min−1 1.73 m−2). Factors associated with progressive decline were baseline renal dysfunction, COPD, and loop diuretic use. Lower renal function at baseline and any decrease over time was strongly associated with worse clinical outcomes, including cardiovascular death and heart failure hospitalization.
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