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Cardiorenal Syndrome: Clinical Outcome Study.

H R Shah1, N P Singh2, N P Aggarwal3

  • 1DNB Resident, Dept. of Medicine.

The Journal of the Association of Physicians of India
|April 14, 2017
PubMed
Summary
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Cardiorenal syndrome (CRS) affects elderly males, with subtypes CRS-1 and CRS-4 showing poorer outcomes. Anemia and reduced kidney function predict adverse events.

Area of Science:

  • Cardiology
  • Nephrology
  • Internal Medicine

Background:

  • Cardiorenal syndrome (CRS) represents a significant medical challenge, involving the interplay between heart and kidney dysfunction.
  • Understanding the complex mechanisms of CRS is crucial for managing patients with coexisting heart and renal insufficiency.

Purpose of the Study:

  • To classify cardiorenal syndrome subtypes in ICU patients.
  • To evaluate clinical outcomes at discharge and three months post-discharge.
  • To identify predictors of non-favorable outcomes in CRS patients.

Main Methods:

  • A longitudinal study of 50 ICU patients with CRS.
  • Classification of patients into subtypes based on the RONCO classification (2008).
  • Outcomes defined as favorable (stable) or unfavorable (hemodialysis or death).

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Main Results:

  • The majority of patients were male (66%), with a mean age around 64 years.
  • Type-1 CRS was most prevalent (46%), followed by Type-4 (26%) and Type-2 (22%).
  • Non-favorable outcomes (dialysis/death) were higher in CRS-4 (22%) and CRS-1 (16%) subtypes. Anemia, elevated creatinine, low eGFR, and low ejection fraction predicted worse outcomes.

Conclusions:

  • CRS affects all age groups, predominantly older males, with higher prevalence of CRS-1 and CRS-4.
  • Prognosis is unfavorable in CRS-1, CRS-4, and CRS-5 subtypes, with sepsis being a major cause of mortality in CRS-5.
  • Pre-existing renal impairment, anemia, reduced eGFR, and low ejection fraction are significant risk factors for adverse outcomes in CRS.