ASSESSMENT OF KIDNEY DYSFUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE

Area of Science:

• Cardiology
• Nephrology
• Medical Imaging

Background:

• Chronic heart failure (CHF) affects millions globally, often co-occurring with kidney dysfunction.
• Kidney function assessment is crucial for managing CHF patients, impacting prognosis and treatment.
• The relationship between renal blood flow and kidney dysfunction severity in CHF requires further elucidation.

Purpose of the Study:

• To investigate the impact of kidney dysfunction on clinical parameters and renal hemodynamics in patients with chronic heart failure (CHF).
• To correlate estimated glomerular filtration rate (eGFR) with exercise tolerance, clinical status, and quality of life (QoL) in CHF patients.
• To analyze changes in renal artery blood flow indices in CHF patients with varying degrees of kidney dysfunction.

Main Methods:

• 150 patients with CHF (FC I-III) were evaluated, with kidney function assessed via serum creatinine and CKD-EPI calculated eGFR.
• Patients were stratified into two groups based on eGFR: >60 ml/min/1.73m² (Group I) and ≤60 ml/min/1.73m² (Group II).
• Renal blood flow was assessed using Doppler ultrasound, measuring pulsatile index (PI), resistance index (RI), and blood flow velocities in lobar and segmental renal arteries.

Main Results:

• Progressive kidney dysfunction in CHF patients correlated with decreased exercise tolerance, worsened clinical condition, and reduced QoL.
• Patients with eGFR ≤60 ml/min/1.73m² exhibited significantly poorer clinical outcomes compared to those with eGFR >60 ml/min/1.73m².
• Renal dysfunction in CHF was associated with increased PI and RI, and decreased diastolic, systolic, and mean blood flow velocities in renal arteries.

Conclusions:

• Kidney dysfunction significantly exacerbates clinical symptoms and reduces quality of life in chronic heart failure patients.
• Doppler ultrasound reveals impaired renal hemodynamics, characterized by increased vascular resistance and reduced flow velocities, in CHF patients with renal dysfunction.
• These findings underscore the importance of monitoring kidney function and renal blood flow in the management of chronic heart failure.