Prevalence of renal impairment in decompensated heart failure patients at King Hussein Medical Center

Abstract EN

Objective : To determine prevalence of renal impairment associated with chronic heart failure, defined as cardiorenal syndrome, in patients treated at King Hussein Medical Center.

Methods : This retrospective review was carried out at King Hussein Medical Center between first of January 2005 and the first of January 2007.

All heart failure patients who were admitted because of decompensated heart failure state were included.

Medical records were reviewed and data was obtained regarding age, sex, body weight, serum creatinine, echocardiography findings, use of angiotensin converting enzyme inhibitors as well as diuretics, and any documentation of atrial fibrillation in the medical records.

Estimated glomerular filtration rate was calculated for all patients.

Results : Five hundred patients met the inclusion criteria.

The male to female ratio was 3 : 2 and their average age was 61 years (± 9.1 years).

Two hundred and ten patients (42%) had moderate to severe left ventricular dysfunction (ejection fraction below 35%), and 290 (58%) were having mild left ventricular dysfunction (ejection fraction more than 35%).

Four hundred (80%) of heart failure patients were on angiotensin converting enzyme inhibitors and diuretics.

Two hundred patients had documented atrial fibrillation in their medical records.

Estimated glomerular filtration rate above 90ml/min was found in 350 patients (70%), a rate between 60-90ml/min was found in 70 patients (14%), a rate between 30-59 ml / min was found in 45 patients (9%), and a rate below 30 m l / min was detected in 35 patients (7%).

The average age of patients with estimated glomerular filtration rate below 90ml / min was 68 years ± 4 years with a male to female ratio of 3 : 2 and 65% of them were having moderate to severe left ventricular impairment.

Seventy five percent of patients with estimated glomerular filtration rate below 90ml / min were having documented atrial fibrillation in their medical records.

Angiotensin converting enzyme inhibitors and diuretics were used in 80% of those with estimated glomerular filtration rate below 90ml / min.

Among the decompensated heart failure patients included in the study, 15 (3%) died during hospitalization and 10 of them (66%) were having estimated glomerular filtration rate below 30ml / min.

Conclusions : In patients undergoing intensive treatment for heart failure, renal dysfunction is common and clinically significant.

Better understanding of the causes and prevention of renal dysfunction during heart failure therapy may lead to better outcomes in the future.