[Analysis of causes of development of anemia in patients with chronic heart failure]

High prevalence of anemia and its direct relation with morbidity and mortality in congestive heart failure (CHF) has been shown in numerous studies. Among etiology factors of anemia are hemodilution, chronic kidney insufficiency, deficiency of iron, folate, and vitamin 12, high level of inflammatory cytokines. Aims of this study were elucidation of causes of anemia in patients with CHF and assessment of dependence of prognosis of these patients on etiology of anemia. We examined 317 patients hospitalized with diagnosis of NYHA class II-IVCHF and anemia (129, [40.7%] men and 188 [59.3%] women, mean age 74.4+/-1.75 years, duration of CHF 4.4+/-0.2 years; 46, 42, 12% with NYHA class IV, III and II, respectively). Causes of anemia were chronic kidney insufficiency, iron deficiency, vitamin B12-deficiency, hemodilution, and chronic diseases. Glomerular filtration rate (GFR) below 50 ml/min was found in 27 patients (8.5%), deficiency of iron with lowered ferritin concentration and/or saturation of transferrin was revealed in 104 (32.8 %), vitamin B12-deficiency in 4 (1.3%), hemodilution in 40 (12.6%) patients. In 142 patients (44.8%) anemia was associated with chronic diseases. Hospital mortality in the whole group was 18.3%. Death rates in patients with hemodilution, chronic kidney insufficiency, vitamin B12-deficiency, anemia due to chronic diseases, and iron deficiency anemia were 32.5, 25.9, 25, 16.2 and 13.5%.