MON-247 INCIDENCE AND SHORT TERM OUTCOME OF TYPE 1 CARDIORENAL SYNDROME IN NEPALESE PATIENTS

Abstract

Heart performance and kidney function are closely related. Dysfunction of heart and kidneys often coexist and one begets other. Acute heart failure and its treatment can lead to acute kidney injury, known as, Type 1 Cardiorenal syndrome (CRS). There is no study on CRS in Nepalese patient. We undertook this study to determine the incidence and short term outcome of AKI in acute heart failure (type 1 CRS). Patients with acute heart failure needing hospitalization, who consented for the study were enrolled from June 2017 to May 2018. Framingham criteria for heart failure and AKIN criteria for AKI were used to define heart failure and AKI respectively. Detailed clinical and relevant investigations (laboratory and imaging) were done and recorded in predefined performa. Patients were followed up on day 7th and at 3 month. A total of 115 patients with acute heart failure needing hospitalization were enrolled in this study. All patients were in NYHA class III or IV. The mean age of the patients was 61.5 ±16.5years. Male constituted 61%. BMI was recorded to be 22.58 ± 3.59. Hypotension on presentation was recorded in 8%. Half of the patients (n=58) was diagnosed to have Acute kidney injury. Presence or absence of history of smoking (55%), systemic hypertension (37%), diabetes mellitus (27%), ischemic heart disease (9%) and COPD (7%) was not associated with higher risk of development of AKI. Twelve patients died during hospital stay (11 with AKI and 1 patient with no AKI). All cause mortality at 3 months was significantly higher in patient with AKI (32.8%; n=19) in comparison to patients without AKI (7%, n=4). Incident of AKI in acute heart failure is high in this study. Acute heart failure patient with AKI (Type 1CRS) had high mortality compare to those without AKI.