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Cardiorenal syndrome type 4: A study of cardiovascular diseases in chronic kidney disease
Suresh H1, Arun B S2, Venkatesh Moger3
1Department of Cardiology, KIMS, Hubli, India.
Insights
Cardiorenal syndrome type 4 is common in chronic kidney disease (CKD) patients, affecting over 76% and leading to adverse outcomes. Early detection and management are crucial for improving patient care.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- The heart and kidneys are closely linked, with dysfunction in one organ often affecting the other.
- Cardiorenal syndrome (CRS) describes these interactions, with CRS type 4 specifically involving cardiac failure in patients with chronic kidney disease (CKD).
Purpose of the Study:
- To determine the prevalence of cardiac diseases in CKD patients.
- To identify risk factors associated with cardiac conditions in this population.
Main Methods:
- Eighty CKD patients were evaluated clinically and through investigations, including echocardiography.
- Data was collected between January 1, 2015, and June 30, 2015.
Main Results:
- The prevalence of CRS type 4 was high at 76.25%.
- Left ventricular hypertrophy (68.75%), heart failure with preserved ejection fraction (73.75%), and pulmonary hypertension (43.75%) were common.
- Lower hemoglobin and higher central venous pressure/fluid retention were linked to left ventricular failure.
Conclusions:
- Cardiorenal syndrome type 4 is highly prevalent in CKD patients.
- This condition is associated with adverse outcomes, underscoring the need for effective patient management strategies.
Introduction:
The heart and the kidneys are tightly interlinked with each other. So, primary disorder of one of these organs often results in the secondary dysfunction of other. Such interactions play a vital role in the pathogenesis of a clinical entity called cardio-renal syndrome (CRS). CRS type 4 refers to the development of cardiac failure in the patients with CKD.
Objectives:
To study the prevalence of various cardiac diseases in the patients with CKD and risk factors for it.
Methods:
Eighty patients with CKD who were being treated at KIMS, Hubli, from 1st January 2015 to 30th June 2015 were selected. Clinical evaluation and relevant investigations including echocardiography were done.
Results:
Mean age of study population was 43.50±14.53 years. Heart failure with reduced ejection fraction (HFrEF) and Heart Failure with preserved ejection fraction (HFpEF) were present in 21 (26.25%) and 59 (73.75%) respectively. Left ventricular (LV) hypertrophy was present in 55(68.75%). Thus, the prevalence of CRS type 4 was 61 (76.25%). Pericardial effusion was present in 12 (15%). Complete heart block was present in 2 (2.5%). Pulmonary hypertension (PH) was present in 35 (43.75%). Mean central venous pressure (CVP) and interdialysis fluid retention were significantly greater among those with LV failure, compared to those without LV failure (p=0.0002, p=0.025 respectively). Mean hemoglobin was significantly lower among patients with LV failure, compared to those without LV failure (p=0.032).
Conclusion:
The prevalence of cardiorenal syndrome type 4 is substantially high in patients with CKD and carries adverse outcome in relation to patient management.
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