[Anemia and heart failure with preserved ejection fraction in adult patients with cardiorenal syndrome: a cross-sectional study]

Introduction: Patients hospitalized for heart failure with preserved ejection fraction (HFpEF) have a higher prevalence of anemia than those hospitalized for heart failure with reduced ejection fraction (HFpEF). However, it is unknown if this relationship is maintained in patients with chronic kidney disease, forming cardiorenal syndrome type IV.

Methods: Cross-sectional, multicenter study of patients with chronic kidney disease hospitalized for heart failure. The primary outcome was the difference in hemoglobin concentration. The secondary outcome was the difference in the prevalence of anemia.

Results: 229 patients were enrolled. Hemoglobin concentration was lower in patients with HFpEF compared to patients with HFrEF (11.1±1.8 g/dl vs 12.3±2.0 g/dl; p < 0.0001). . Presenting HFpEF was associated with a lower hemoglobin concentration (β1 = -0.90 g/dl; p = 0.001), after including the use of iron supplements, moderate to severe deterioration of glomerular filtration rate, sex and age. The prevalence of anemia was higher in patients with HFpEF compared to those with HFrEF (72.3% vs 59.8%; p = 0.0462). Belonging to the HFpEF group was not associated with anemia (OR = 1.77; p = 0.078), after including the same covariates. Exploratory, belonging to the HFpEF group was associated with moderate to severe anemia, after including the same covariates.

Conclusion: In patients with type IV cardiorenal syndrome, hemoglobin concentration is lower in patients hospitalized with HFpEF, possibly playing a role in the destabilization of these patients.