Cardiorenal syndrome in acute heart failure: A vicious cycle? Article Swipe
Francisca Caetano
,
Sérgio Barra
,
Ana Faustino
,
Ana Botelho
,
Paula Mota
,
Marco Costa
,
António Leitão Marques
·
YOU?
·
· 2014
· Open Access
·
· DOI: https://doi.org/10.1016/j.repce.2013.09.011
YOU?
·
· 2014
· Open Access
·
· DOI: https://doi.org/10.1016/j.repce.2013.09.011
Introduction and Objective: Worsening renal function has an unquestionably negative impact on prognosis in patients with acute heart failure (HF). In Portugal there is little information about the importance of this entity in HF patients admitted to hospital. The objective of this work was to assess the prevalence of cardiorenal syndrome and to identify its key predictors and consequences in patients admitted for acute HF. Methods: This was a retrospective study of 155 patients admitted for acute HF. Cardiorenal syndrome was defined as an increase in serum creatinine of ≥26.5 μmol/l. Clinical, laboratory and echocardiographic parameters were analyzed and compared. Mortality was assessed at 30 and 90 days. Results: Cardiorenal syndrome occurred in 46 patients (29.7%), 5.4±4.4 days after admission; 66.7% (n=24) did not recover baseline creatinine levels. The factors associated with cardiorenal syndrome were older age, chronic renal failure, moderate to severe mitral regurgitation, higher admission blood urea nitrogen, creatinine and troponin I, and lower glomerular filtration rate. Patients who developed cardiorenal syndrome had longer hospital stay, were treated with higher daily doses of intravenous furosemide, and more often required inotropic support and renal replacement therapy. They had higher in‐hospital and 30‐day mortality, and multivariate analysis identified cardiorenal syndrome as an independent predictor of in‐hospital mortality. Conclusions: Renal dysfunction is common in acute HF patients, with a negative impact on prognosis, which highlights the importance of preventing kidney damage through the use of new therapeutic strategies and identification of novel biomarkers. Resumo: Introdução e objetivos: O valor prognóstico da deterioração da função renal é indiscutível nos doentes com insuficiência cardíaca aguda. No contexto nacional sabe‐se pouco acerca do peso relativo da síndrome cardiorrenal no internamento destes doentes. Este trabalho pretende avaliar a prevalência, fatores preditores e consequências desta entidade em doentes internados por insuficiência cardíaca aguda. Métodos: Análise retrospetiva de 155 doentes internados por insuficiência cardíaca aguda. Síndrome cardiorrenal definida como um aumento ≥ a 26,5 umol/L na creatinina sérica relativamente ao valor da admissão. Avaliados e comparados dados clínicos, analíticos e ecocardiográficos. Feito seguimento, referente a mortalidade, aos 30 e 90 dias. Resultados: A síndrome cardiorrenal ocorreu em 46 (29,7%) doentes, 5,4±4,4 dias após a admissão; 66,7% (n=24) não recuperaram a função renal basal. Associaram‐se ao desenvolvimento desta entidade: idades mais avançadas; antecedentes de insuficiência renal crónica; insuficiência mitral moderada/grave; níveis na admissão mais elevados de ureia, creatinina e troponina I; e mais baixos de taxa de filtração glomerular. Os doentes com síndrome cardiorrenal tiveram internamentos mais longos; necessitaram de doses diárias máximas de furosemida mais elevadas; mais frequentemente necessitaram de inotrópicos e de terapêutica de substituição renal. A sua mortalidade no internamento e aos 30 dias foi superior, sendo a síndrome cardiorrenal um fator preditor independente de mortalidade intra‐hospitalar. Conclusões: A disfunção renal é comum em doentes com insuficiência cardíaca aguda, com impacto claramente negativo no prognóstico, devendo a prevenção da lesão renal ser um objetivo primário passando por novas estratégias terapêuticas e identificação de novos biomarcadores. Keywords: Acute heart failure, Cardiorenal syndrome, Prognosis, Palavras‐chave: Insuficiência cardíaca aguda, Síndrome cardiorrenal, Prognóstico
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1016/j.repce.2013.09.011
- OA Status
- hybrid
- Cited By
- 9
- References
- 30
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2154749841
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2154749841Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1016/j.repce.2013.09.011Digital Object Identifier
- Title
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Cardiorenal syndrome in acute heart failure: A vicious cycle?Work title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2014Year of publication
- Publication date
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2014-03-01Full publication date if available
- Authors
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Francisca Caetano, Sérgio Barra, Ana Faustino, Ana Botelho, Paula Mota, Marco Costa, António Leitão MarquesList of authors in order
- Landing page
-
https://doi.org/10.1016/j.repce.2013.09.011Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1016/j.repce.2013.09.011Direct OA link when available
- Concepts
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Cardiorenal syndrome, Medicine, Renal function, Heart failure, Creatinine, Acute decompensated heart failure, Internal medicine, Blood urea nitrogen, Cardiology, Inotrope, Acute kidney injury, Intensive care medicineTop concepts (fields/topics) attached by OpenAlex
- Cited by
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9Total citation count in OpenAlex
- Citations by year (recent)
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2024: 2, 2022: 1, 2021: 4, 2017: 2Per-year citation counts (last 5 years)
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30Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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