Características, tratamiento y pronóstico a 1 año de los pacientes con insuficiencia cardíaca y enfermedad renal crónica estadios 4 o 5

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola Pub Date : 2026-08-01 Epub Date: 2026-06-04 DOI:10.1016/j.rce.2026.502578

M. Anguita-Gámez, J.L. Bonilla-Palomas, A. Esteban-Fernández, A. Recio-Mayoral, J. Muñiz, R. González-Manzanares, M. Ruiz-Ortiz, M. Anguita-Sánchez, D. Mesa-Rubio

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Abstract

Aims

To analyze, in a contemporary registry of patients with heart failure (HF), the differences in characteristics, treatment, and 1-year prognosis between patients with chronic kidney disease (CKD) stages 4-5 versus CKD 1-3.

Methods

We analyzed the SEC-Excelente-HF registry of the Spanish Society of Cardiology, that included 2,245 patients between 2018 and 2023 by 68 HF units. Characteristics, treatment, mortality, and hospitalization rates for HF at 1 year were compared between patients with an estimated glomerular filtration rate (eGFR) < 30 ml/minute/m² and those with an eGFR ≥ 30 ml/min/m².

Results

Of the 2,245 patients, 9.9% had CKD 4-5 and 90.1% had an eGFR ≥ 30 ml/min/m². Ejection fraction was similar (42.8 ± 15.4 vs. 40.3 ± 15.3%). The CKD 4-5 group was older (76.9 ± 9.6 vs. 70.5 ± 12.4 years; P < .001) and showed a higher prevalence of ischemic heart disease, diabetes mellitus, anemia, and iron deficiency. These patients received in a lower proportion all drugs for HF (P < .001), except diuretics and potassium binders. Mortality rate (36.1 vs. 14.6/100 person-years; P < .001) and the rate of HF hospitalizations at one year (67.3 vs. 30.9/100 person-years; P < .001) were higher in patients with CKD stages 4-5.

Conclusions

In a contemporary cohort of patients with HF, patients with CKD stages 4-5 had different clinical characteristics, received in a lesser proportion adequate treatment, and had higher 1-year mortality and HF hospitalization rates.

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4 - 5期心力衰竭和慢性肾病患者的特征、治疗和1年预后

目的：分析当代心力衰竭（HF）患者的登记资料，慢性肾脏疾病（CKD） 4-5期与CKD 1-3期患者在特征、治疗和1年预后方面的差异。方法：我们分析了西班牙心脏病学会的SEC-Excelente-HF注册表，其中包括2018年至2023年期间的2245例患者，共68个HF单位。比较肾小球滤过率(eGFR)≥30 ml/min/m2和eGFR≥30 ml/min/m2的HF患者1年的特征、治疗、死亡率和住院率。结果在2245例患者中，9.9%的患者为CKD 4-5, 90.1%的患者eGFR≥30 ml/min/m2。射血分数相似（42.8±15.4比40.3±15.3%）。CKD 4-5组年龄更大（76.9±9.6岁vs 70.5±12.4岁；P < .001），缺血性心脏病、糖尿病、贫血和缺铁的患病率更高。除利尿剂和钾结合剂外，这些患者接受所有HF药物治疗的比例较低（P < .001）。4-5期CKD患者的死亡率（36.1 vs. 14.6/100人年；P < 0.001）和一年内HF住院率（67.3 vs. 30.9/100人年；P < 0.001）更高。结论在当代心衰患者队列中，4-5期CKD患者临床特征不同，接受适当治疗的比例较低，1年死亡率和心衰住院率较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista clinica espanola 医学-医学：内科

CiteScore

4.40

自引率

6.90%

发文量

审稿时长

28 days

期刊介绍： Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI). The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Nine issues are published each year, including mostly originals, reviews and consensus documents.