0236: Association of chronic kidney disease and cardiovascular disease in ambulatory cardiac rehabilitation center

Abstract

Chronic kidney disease (CKD) is a frequent co morbidity among elderly patients and those with cardiovascular disease. CKD carries prognostic relevance. A goal of the present study was to describe patient characteristics and functional capacity of patients in cardiac rehabilitation (CR), differentiated by presence or absence of CKD. Between June 2011 and July 2013, 304 patients were consecutively referred to our institution after an acute event (cardiac surgery, acute coronary syndrome or acute heart failure). Our CR program consists of 4 sessions per week for 5 weeks (total of 20 sessions) and includes both exercise and health and nutrition education sessions. Glomerular filtration rate (GFR) was calculated based on the Modification of diet in renal disease (MDRD) formula and CKD was defined as estimated GFR <60ml/min/1.73m 2 . Patients were divided into two groups according to their renal function. The prevalence of CKD, in our ambulatory cardiac rehabilitation center was 17% (53 patients). Compared with non-CKD patients, CKD patients were significantly older (68±8 versus 59±11years; p=0.01), had more arterial hypertension (81% versus 51%; p=0.000), and mean low density lipoprotein cholesterol (LDL-C), and total cholesterol were significantly higher (p=0.01). Exercise capacity was much lower in CKD patients (W peak (watt): 74 vs. 94; (p=0.000), VO2 peak/kg (ml/kg): 16 vs 20 (p=0.000)). In CKD patients, mean low density lipoprotein cholesterol (LDL-C), and total cholesterol were significantly higher than in non-CKD ones. At discharge, blood pressure, lipid profile and physical fitness on exercise testing improved substantially in both groups. Within a short period of 5 weeks, CR led to substantial improvements in key risk factors such as lipid profile, blood pressure, and physical fitness for all patients, even if CKD was present.