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Cardiorenal Anemia Syndrome and Survival among Heart Failure Patients in Tanzania: A Prospective Cohort Study

Pedro Pallangyo1, Francis Fredrick2, Smita Bhalia3

  • 1Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania. pedro.pallangyo@gmail.com.

BMC Cardiovascular Disorders
|February 15, 2017
PubMed

Insights

Cardiorenal anemia syndrome (CRAS) is common in Tanzanian heart failure patients, significantly increasing mortality. Early intervention to manage anemia and renal function is crucial for improving survival rates.

Area of Science:

  • Cardiology
  • Nephrology
  • Hematology
  • Public Health

Background:

  • Cardiorenal anemia syndrome (CRAS) is a growing global health concern, linked to higher morbidity, mortality, and healthcare costs.
  • Managing CRAS patients presents significant challenges worldwide, exacerbated by a lack of evidence-based clinical guidelines.
  • This study investigates the prevalence and survival rates of CRAS in heart failure patients within Tanzania.

Purpose of the Study:

  • To determine the prevalence of Cardiorenal Anemia Syndrome (CRAS) among heart failure patients in Tanzania.
  • To analyze the survival rates of heart failure patients with and without CRAS in the Tanzanian population.
  • To identify predictors of mortality in heart failure patients with CRAS.

Main Methods:

  • A cohort of 463 heart failure patients meeting inclusion criteria were recruited from 789 screened individuals.
  • Participants underwent comprehensive assessments including interviews, physical examinations, anthropometric measurements, anemia evaluation, renal function tests, and echocardiography.
  • A Cox proportional-hazards regression model was employed to compare mortality between CRAS and non-CRAS groups, with follow-up for up to 180 days.

Main Results:

  • The study population had a mean age of 46.4 years, with 56.5% being women. Renal insufficiency was present in 51.9%, anemia in 72.8%, and CRAS in 44.4% of participants.
  • Overall mortality was 57.8% during a mean follow-up of 103 days. Patients with CRAS exhibited a significantly higher mortality rate (73.5%) compared to those without CRAS (45.8%) (p < 0.001).
  • Multivariate analysis identified renal dysfunction (HR 1.9), severe anemia (HR 1.8), hyponatremia (HR 2.2), and rehospitalization (HR 4.3) as strong predictors of mortality.

Conclusions:

  • Cardiorenal anemia syndrome is highly prevalent in Tanzanian heart failure patients and is strongly associated with increased mortality.
  • Timely, aggressive, and collaborative interventions to improve renal function and correct anemia are essential for managing CRAS patients.
  • The findings underscore the urgent need for guideline committees to develop or revise evidence-based recommendations for CRAS management.
Abstract

Keywords:
AnemiaCRASHeart failureMortalityRenal insufficiency

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