Renal dysfunction in African patients with acute heart failure

Area of Science:

• Cardiology
• Nephrology
• Public Health

Background:

• Renal dysfunction in acute heart failure is well-documented in elderly Western populations.
• Data on younger, non-ischaemic acute heart failure patients in Africa is limited.

Purpose of the Study:

• To describe the prevalence, predictors, and clinical outcomes of renal dysfunction in younger African acute heart failure patients.
• To compare these findings with Western cohorts.

Main Methods:

• Analysis of 1006 patients from the sub-Saharan Africa Survey of Heart Failure (THESUS-HF).
• Renal function assessed by estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula.
• Worsening renal function defined as an increase in creatinine ≤0.3 mg/dL from baseline to day 7/discharge.

Main Results:

• 30.6% of patients presented with renal dysfunction (eGFR ≤60 ml/min/1.73 m2).
• Worsening renal function occurred in 9.8% of patients and was associated with the Western sub-Saharan region, body mass index, and rales.
• Worsening renal function independently predicted death or readmission within 60 days and all-cause death within 180 days.

Conclusions:

• Renal dysfunction is prevalent in younger African acute heart failure patients.
• Worsening renal function, though less prevalent than in Western cohorts, has distinct predictors and significantly impacts clinical outcomes.