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[Frequency of kidney failure in cardiologic patients: the need to search]
Insights
Chronic kidney disease is common in cardiology patients, affecting 20.8%. Hypertension and age are key risk factors for this serious condition, highlighting the need for early detection in cardiac care.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Context:
- Chronic kidney disease (CKD) presents a significant global health challenge, linked to elevated cardiovascular risks, increased morbidity and mortality, and substantial treatment costs.
- Cardiology clinics manage patients with high cardiovascular risk, making them a critical setting for identifying comorbid conditions like CKD.
Purpose:
- To determine the prevalence of chronic kidney disease (CKD) among individuals seeking consultation at a cardiology clinic.
- To identify risk factors associated with kidney failure in a cardiac patient population.
Summary:
- A cross-sectional study of 649 cardiology patients revealed a 20.8% prevalence of kidney failure, with higher rates (28.4%) in those aged 65 and older.
- Kidney failure was predominantly mild to moderate (Stage 3), with 84% classified as chronic. A significant portion (28%) had 'hidden' kidney failure, often in women with normal creatinine levels.
- Multivariate analysis identified hypertension (OR 4.2), advanced age (OR 1.1), reduced ventricular ejection fraction (OR 0.97), and low hemoglobin (OR 0.735) as independent risk factors for kidney failure.
Impact:
- This study underscores the high frequency of undiagnosed or undertreated kidney disease in cardiac patients.
- Identifying key risk factors such as hypertension and age can guide targeted screening and management strategies to mitigate cardiovascular and renal complications.
- Findings emphasize the importance of integrating renal function assessment into routine cardiovascular care to improve patient outcomes.
Background:
Chronic kidney disease is a major health problem since it is associated with a high cardiovascular risk, total morbidity and mortality, increasing prevalence and high cost treatment.
Aim:
To assess the frequency of chronic kidney disease among patients consulting in a cardiology clinic.
Material And Methods:
Cross-sectional assessment of 649 patients attended at a cardiology clinic. Demographic, clinical, electrocardiographic, echocardiographic and laboratory variables were registered. Patients were considered to have a kidney failure when their estimated glomerular filtration rate was < 60 ml/min/1.73 m² according to the Modification of Diet in Renal Disease (MDRD) formula. Kidney failure was considered chronic if this alteration lasted ≥ 3 months and hidden when serum creatinine levels were normal.
Results:
The frequency of kidney failure was 20.8% (28.4% in patients ≥ 65 years old). The mean age of patients with the disease was 71.5 ± 9.1 years and 52% were women. Eighty seven percent were in stage 3, 10% in stage 4 and 3% in stage 5. Among patients with kidney failure, in 114 (84%) it was chronic and in 28%, hidden. The latter was observed almost exclusively in women with creatinine levels of approximately 1 mg/dl. Hypertension (Odds ratio (OR) 4.2), age (OR 1.1), ventricular ejection fraction (OR 0.97) and low hemoglobin (OR 0.735) were the risk factors for kidney failure detected in the multivariate analysis.
Conclusions:
The frequency of kidney failure (chronic or hidden) was high in this group of cardiologic patients. Most patients had a mild to moderate failure and the risk factors were hypertension, age, low ventricular ejection fraction and low hemoglobin levels.
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