Impact of Acute Kidney Injury in Patients with Acute Decompensated Heart Failure: Cardiorenal Syndrome

Abstract

Introduction: 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 evaluate cardiac and renal function‚ treatment factors‚ and outcomes because of mortality and persistent renal dysfunction in acute decompensated heart failure (cardiorenal syndrome type 1) patients. Methods: We studied 100 patients hospitalized 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 because of mortality and persistent renal dysfunction. The study monitored the patients until discharge and followed up with three months to one year. Record information about functional improvement‚ worsening symptoms‚ and mortality. Results: 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 Àltration rate eGFR 0. 2 5% CI 0.87 to 0. 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 an increased risk of mortality (25%)‚ and residual renal dysfunction (16%) at one-year follow-up. . Conclusion: Persistent renal dysfunction‚ renal replacement therapy possibly improve the treating persistent renal dysfunction‚ and recurrent HHF (more than 2 admissions) post-hospitalization index within twelve months were predictors of mortality (25%) at one year.