Short-Term outcomes and their predictors among patients with cardiorenal syndrome hospitalized for heart failure

Abstract

Context: Cardiorenal syndrome (CRS) encompasses a spectrum of disorders involving both the heart and kidneys in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Aim: To review the short-term outcomes and their predictors among patients admitted with HF complicated by renal impairment. Settings and Design: This was a cross-sectional study conducted at the Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: Patients aged 18 years and above were consecutively recruited over a period of 11 months. Detailed history and physical examination as well as relevant baseline blood chemistry, full blood count, urinalysis, estimated glomerular filtration rate, ECG, echocardiography, and renal ultrasound were carried out on all patients. Statistical analysis used: The data was analyzed using SPSS Version 16.0. Student t-test and the nonparametric χ2 or Fisher's exact test were used to test for significance among the noncategorical and categorical variables, respectively. Results: One hundred and twenty four (72.9%) patients had CRS. Patients with CRS had a significantly higher mortality rate compared with those without the syndrome (25% vs. 13%; P = 0.031). There was no significant difference in the duration of hospital stay between patients with CRS and those without CRS (17.86 ± 13.11 vs. 15.85 ± 13.46; P = 0.378). Serum creatinine of ≥170 μmol/L and serum urea of >20 mmol/L were the identified predictors of mortality (95% confidence interval [CI] 1.098–6.243, RR = 2.618, P = 0.030; and 95% CI 1.106–6.757, RR = 2.734, P = 0.029, respectively). Conclusion: CRS is associated with a significantly higher mortality rate. Measures of the renal function, serum creatinine >170 μmol/L and serum urea of >20 mmol/L were identified as the predictors of mortality.