Chronic kidney disease as a prognostic factor in congestive heart failure: A Moroccan series of 3412 patients.

Abstract

The prevalence of CHF increases greatly as the patient's renal function deteriorates, and, at end-stage CKD, can reach 65–70%. There is evidence that CKD is a major contributor to severe cardiac damage. Purpose is to determine whether end-stage CKD is a prognostic factor in CHF. Transversal retrospective study conducted between May 2006 and June 2019 including patients beyond age of 14 with CHF followed-up in therapeutic unit of heart failure of our department. Data were collected on Excel and statistical analysis was made using SPSS statistics 2.0.We define 2 groups of patients. Group A with end-stage CKD and group B without end-stage CKD.We studied demographic, clinical and paraclinical characteristics among these 2 groups. We collected 3412 patients, 439 (12%) in group A and 2973 (82%) in group B. Main etiology of CHF was ischemic heart disease in both groups. Hypertension and dyslipidemia were more prevalent in group A. Diabetes was as prevalent in 2 groups. Comorbidities were more prevalent in group A as we observe more strokes (20% vs. 8%, P = 0,0001) and myocardial infarctions (31% vs. 28%, P = 0,0001). Group A patients were more symptomatic: stage III and IV NYHA in 30% vs. 19%, P = 0,0001. Patients of group A were more at risk of acute decompensated heart failure (21% vs. 9%, P = 0,005). Atrial fibrillation was more prevalent in group A (14% vs. 9%, P = 0,0001). Elevated left ventricle filling pressure was more prevalent in group A (40% vs. 34%, P = 0,003). Mean LVEF was 35,69 ± 12,56% in group A vs. 33,46 ± 10,42% in group B ( P = 0,63). Left ventricle was more dilated in group A (59,24 ± 8,2 mm vs. 57,91 ± 9,31 mm, P = 0,020). Cooperation between nephrologists and cardiologists may improve quality of care and subsequent prognosis for CHF and CKD.