der routine nephrological care were enrolled across nine German study centers. At the time of screening, male and female patients aged 18 to 74 years had an estimated glomerular filtration rate of 3060 ml/min/1.73m2, or 2 / 16 Heart Failure in Chronic Kidney Disease overt proteinuria in the presence of higher eGFR. Exclusion criteria were non-Caucasian ethnicity, active malignancy, previous transplantations, HF stage NYHA IV, and legal attendance. All participants gave written informed consent, and the German Chronic Kidney Disease study was approved by the Ethics Committees of all participating institutions. Data Collection At the baseline visit, trained and certified personnel used standardized questionnaires to obtain information about the patients medical history, socio-demographic and life-style factors, medication intake and signs and symptoms of HF. The physical examination included measurements of body weight and height, heart rate and three measurements of resting blood pressure. Further information on the patients’ medical history as well as additional medical records were obtained from the patients’ treating nephrologists. Assessment of Heart Failure The Gothenburg score is a validated HF screening tool for epidemiological studies composed of three components: a cardiac score, angina pectoris, edema, dyspnea at night, pulmonary rales or atrial fibrillation), dyspnea on exertion, and the intake of HF medication. The presence of manifest HF defined as Gothenburg stage 2 or stage 3 was evaluated. Pulmonary rales were not included since auscultation was not part of the physical exam. Developed in 1987, the original Gothenburg score defined digitalis or loop diuretics as typical HF medication. To allow for changes in treatment regimens over time, we included additional HF medication and established a modified definition that was used for the analyses in this report and was MedChemExpress SB 203580 19768747″ title=View Abstract(s)”>PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19768747 evaluated in several validation analyses. HF according to the Gothenburg PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19768415 definition was compared to self-reported HF, which was assessed by asking the patients “Are you suffering from heart failure/weakness of the heart”. Baseline Variables All laboratory values were measured in a central certified laboratory using standardized protocols as described in detail previously. Kidney function and damage was assessed by eGFR and the Urine Albumin-to-Creatinine Ratio using the central laboratory measures from the baseline visit. GFR was estimated using the CKD-EPI formula and categorized according to the KDIGO clinical practice guideline into 90, 60-<90, 45-<60, 30-<45 and <30 ml/min/1.73m2. These values may differ from the screening values obtained from the treating nephrologists and resulted in the inclusion of some patients with an eGFR <30 ml/min/1.73m2. Differences in creatinine values between screening and baseline can be explained by the time difference between the screening and the baseline visit, and/or by differences in the creatinine assay and/or procedures between the central laboratory and the laboratories used by the treating nephrologists. UACR was calculated as measured urinary albumin/urinary creatinine and categorized according to the KDIGO classification into <30, 30-<300 and 300 mg/g. Systolic and diastolic 3 / 16 Heart Failure in Chronic Kidney Disease blood pressure ) were determined as the average of up to three measured values. Hypertension was defined according to the Guidelines of the European Society of Hypertension and the European Society o
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