2010 Volume 74 Issue 8 Pages 1578-1583
Background: The aim of the present study was to verify the effects of β-blockers on renal function in patients with heart failure (HF). Methods and Results: A total of 40 patients with HF (New York Heart Association class, II-III) were enrolled, who had β-blocker therapy initiated with carvedilol (n=23) or metoprolol (n=17). The changes in renal and cardiac function were retrospectively analyzed over 16 weeks. The study population was divided into 2 groups according to the median baseline (65.9 ml/min) of estimated glomerular filtration rate (eGFR) calculated by the Modification of Diet in Renal Disease formula. eGFR significantly decreased in the higher eGFR group (P=0.04), but did not in the lower eGFR group. Left ventricular ejection fraction significantly increased in both groups with lower eGFR (P=0.01) and higher eGFR (P<0.01). There was an interaction between plasma norepinephrine concentration and eGFR in terms of β-blocker treatment (P=0.02, ANOVA). eGFR significantly decreased in patients who received metoprolol (from 75.7±33.5 to 59.5±20.0 ml·min-1·1.73 m-2, P<0.01), but did not change in those who received carvedilol (from 67.1±27.7 ml·min-1·1.73 m-2 to 65.6±23.2 ml·min-1·1.73 m-2). Conclusions: β-Blockers preserved renal function in HF patients with lower baseline eGFR, but not in those with higher baseline eGFR. Carvedilol may be preferable to metoprolol to prevent the development of chronic kidney disease during β-blocker therapy for HF. (Circ J 2010; 74: 1578 - 1583)
