Glomerular filtration rate as a prognostic factor for long-term mortality after acute pulmonary embolism.

OBJECTIVE: <br>To determine the impact of estimated glomerular filtration rate (eGFR) and creatinine clearance (CrCl) on long-term all-cause mortality following acute PE in association with other routine laboratory analyses and comorbidities.<br> Materials (Subjects) and Methods<br>The prospective study enrolled 141 consecutive patients presenting with objectively confirmed acute PE. Demographic, clinical data, comorbidities and laboratory values were recorded. CrCl and GFR was estimated using Cockcroft-Gault, MDRD and CKD-EPI equations. Patients were followed up at 90 days and one year after the event.<br> Results: <br>In univariate analyses, age, active cancer, pulmonary embolism severity index (PESI), CrCl and eGFR, D-dimer value, and high-density lipoprotein level were found to be significantly associated with mortality in 90 days and one year. Additionally, body-mass index was significant in one-year follow-up. CrCl by Cockcroft-Gault (90-day: AUC=0.763; one-year: AUC=0.718) demonstrated higher discriminatory power for predicting mortality than eGFR by MDRD (AUC=0.686; AUC=0.609) and CKD-EPI (AUC=0.697; AUC=0.630) equations. In multivariate analyses, active cancer, CrCl by Cockcroft-Gault (90-day: HR 0.948, 95% CI 0.919-0.979; one-year: HR 0.967, 95% CI 0.943-0.991), eGFR by CKD-EPI (90-day: HR 0.948, 95% CI 0.915-0.983; one-year: HR 0.971, 95% CI 0.945-0.998) were found to be independent predictors for mortality. eGFR by MDRD, D-dimer and PESI value were significant prognostic factors for 90-day mortality.<br> Conclusion:<br>Decreased renal function is a prognostic factor for increased all-cause mortality in 90 days and one year after acute PE.<br>.