Impact of acute kidney injury in patients with acute decompensated heart failure: Cardiorenal syndrome

Worsening renal function in patients with acute heart failure

  • Sagar Tandel, Dr. Consultant Interventional Cardiologist
  • Ashish Mishra, Dr. Consultant Interventional Cardiologist
  • Sharad Jain, Dr. Professor
  • Vishal Sharma, Dr. Associate Professor https://orcid.org/0000-0002-3838-6397
  • Kewal Kanabar, Dr. Assistant Professor
  • Pooja Vyas, Dr. Professor
  • Krutika Patel, Ms. Research Associate
  • Nisarg Desai, Dr. D.M. Resident
  • Aman Kedia, Dr. DM Resident
Keywords: Cardiorenal syndrome, Acute decompensated heart failure, Acute kidney injury, Worsening renal function, Mortality

Abstract

Cardiorenal syndrome (CRS) is a complex interdependent relationship between the heart and kidneys, prevalent in hospitalized patients with acute decompensated heart failure (ADHF). The main aim of this study is to evaluation of cardiac and renal function, treatment factors, and outcomes in view of mortality and persistent renal dysfunction in acute decompensated heart failure (cardio renal syndrome type 1) patients. We studied 100 patients hospitalised with ADHF and acute kidney injury (AKI). Patients were evaluated clinically, biochemically, ultrasonographically, and echocardiographically to assess demographics, etiologic and risk factors, cardiac and renal function, and outcomes in view of mortality and persistent renal dysfunction. The study monitored the patients until discharge and follow up with three months to one year. Record information about functional improvement, worsening symptoms, and mortality. The majority of the patients were males (72%), with dyspnea being the most common symptom (92%) followed by decreased urinary output (82%). The mean age of the patients was 62.60 years. Low level of Mean arterial pressure (MAP) 18.97 (95% CI 4.59 to 78.37, P 0.0001), estimated glomerular filtration rate (eGFR) 0.92(95% CI 0.87 to 0.99; P 0.02), maximum creatinine 3.08 (95% CI 1.67 to 5.67, P 0.0001), maximum level of urea 1.02(95% CI, P 0.001), lower Left ventricular ejection fraction (LVEF) 1.05 (95% CI 0.15 to 0.84, P 0.04) were independently predictors of in-hospital mortality. CRS-1 is associated with increased risk of mortality (25%), residual renal dysfunction (16%) at one year follow up. Persistent renal dysfunction, renal replacement therapy possibly improves for the treating persistent renal dysfunction, and recurrent HHF (more than 2 admissions) post hospitalisation index within twelve months were predictors of mortality (25%) at one-year.

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Author Biographies

Sagar Tandel, Dr., Consultant Interventional Cardiologist

Department of Cardiology,Polaris Hospital,Navi Mumbai 

Ashish Mishra, Dr., Consultant Interventional Cardiologist

Department of cardiology, Wockhardt Hospitals, Mumbai-400011, India

Sharad Jain, Dr., Professor

Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India

Vishal Sharma, Dr., Associate Professor

Department of cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India

Kewal Kanabar, Dr., Assistant Professor

 Department of cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India

Pooja Vyas, Dr., Professor

Professor, Department of cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India

Krutika Patel, Ms., Research Associate

Department of Research ,U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India

Nisarg Desai, Dr., D.M. Resident

Department of cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India

Aman Kedia, Dr., DM Resident

Department of cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India

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Published
2024-03-29
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How to Cite
Tandel, S., Mishra, A., Jain, S., Sharma, V., Kanabar, K., Vyas, P., Patel, K., Desai, N., & Kedia, A. (2024). Impact of acute kidney injury in patients with acute decompensated heart failure: Cardiorenal syndrome. Indonesian Journal of Cardiology, 44(2), 75-86. https://doi.org/10.30701/ijc.1561