Renal dysfunction in congestive heart failure, pathophysiological and prognostic significance

Area of Science:

• Cardiology
• Nephrology
• Internal Medicine

Background:

• Congestive heart failure (CHF) patients frequently have comorbidities that worsen outcomes.
• Renal failure (RF) is a significant comorbidity in CHF, independently increasing mortality risk.

Purpose of the Study:

• To identify clinical, laboratory, and electrocardiographic parameters differentiating CHF patients with and without RF.
• To analyze the impact of these parameters, particularly RF, on mortality in CHF patients.

Main Methods:

• Studied 398 consecutive furosemide-treated CHF patients.
• Divided patients into RF (serum creatinine ≥ 1.5 mg/dl) and non-RF subgroups.
• Collected data on demographics, clinical status, laboratory tests, ECG, and followed up for mortality.

Main Results:

• 163 patients (40.9%) had RF. RF subgroup was older, more likely male, and had higher rates of pulmonary edema, arrhythmias, severe CHF, and anemia.
• Mortality was significantly higher in the RF subgroup (54.9%) compared to the non-RF subgroup (31.9%) (p < 0.001).
• In the RF subgroup, older age, female gender, and diabetes mellitus were associated with poorer survival.

Conclusions:

• Renal failure is a marker of CHF severity with a significant negative prognostic impact, evident at serum creatinine levels of 1.5 mg/dl.
• Older age, diabetes mellitus, and female gender are critical factors predicting reduced survival in CHF patients with RF.
• These patients necessitate specialized medical care to improve outcomes.