The Pattern of Aggravated Renal Dysfunction in Patients with Advanced Heart Failure

Abstract

Advanced Heart Failure (AHF) is associated with significant mortality which could be affected by renal dysfunction The objective of the study was to describe the pattern of renal dysfunction in patients with AHF and I investigate whether the dysfunction is a predictor of mortality. Fifty-four patients with AHF \\ho underwent intravenous diuretic therapy were studied. Aetiology of AHF was determined clinically and by echocardiography. Baseline renal functions were determined before and after treatment. The glomerular filtration rate(GFR) was determined using the Cockcroft-Gault equation. The correlation was determined using Pearson's correlation coefficient and risk of death estimated using Cox regression analysis. We found out that aggravated renal Dysfunction(ARD) occurred in 18(33%) of all the patients and was associated with increased mortality ,RR 3.23 p<0.05). The baseline GFR of the patients \\as 68.5±25.5 ml/min and also correlated with mortality ( r= -.486, p< 0.05). Patients with GFR <40mll min had more than 2 times risk of death than those with GFR > 40mllmin (RR 2.65, p<0.05).The other parameters that correlated with mortality included :-baseline creatinine(r = .671, p=0.002) and presence ·:,f atrial fibrillation (r = .532, P = 0.045). NYHA classification did not correlate with mortality in this study. In conclusion, ARD is common in our patients with AHF and it is associated with an increased mortality as some other renal parameters.