Abstract
Background Few studies regarding chronic kidney disease (CKD) and anemia have been conducted in patients with Chagas cardiomyopathy (CC). We evaluated the risk prediction performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and anemia in CC patients. Methods From 2000 to 2010, a total of 232 patients were studied in a single-center retrospective study. CKD was defined as creatinine clearance <60 mL/min/1.73 m2 according to CKD-EPI equation. Anemia was defined as hemoglobin <12 g/dL (women) and <13 g/dL (men). Cox proportional hazards models were used to establish predictors for death. Results At baseline, 98 individuals (42.2%) had criteria for CKD and 41 (17.7%) for anemia. During follow-up, 136 patients (58.6%) died. Independently, CKD and anemia were not associated with all-cause mortality. However, when they coexisted, an additional risk was attributed for these patients. Cox proportional hazard models analysis identified systolic blood pressure (hazard ratio, 0.99; 95% confidence interval (CI), 0.98 to 1.00; P=0.015), implantable cardioverter-defibrillator (hazard ratio, 0.48; 95% CI, 0.27 to 0.85; P=0.012), left anterior fascicular block (hazard ratio, 1.52; 95% CI, 1.08 to 2.13; P=0.017), left ventricular end-diastolic diameter (hazard ratio, 1.04; 95% CI, 1.02 to 1.06; P < 0.001), and serum sodium (hazard ratio, 0.95; 95% CI, 0.92 to 0.99; P=0.020) as independent predictors for death. Conclusions CKD and anemia are not independent predictors for long-term mortality in CC patients. However, the prognosis is poorer in individuals with both comorbidities.
Highlights
Chronic systolic heart failure (CHF) is an insidious syndrome that results in a varying degree of functional impairment, despite the modern CHF therapy [1]
CHF secondary to Chagas cardiomyopathy (CC) has a poor prognosis compared to other etiologies [2, 3], and CC remains the leading cause of CHF in areas where the disease is endemic [4]
In 2009, a new estimating equation for Glomerular filtration rate (GFR) was proposed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) [7], providing better risk predictions
Summary
Chronic systolic heart failure (CHF) is an insidious syndrome that results in a varying degree of functional impairment, despite the modern CHF therapy [1]. In 2009, a new estimating equation for GFR was proposed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) [7], providing better risk predictions. Anemia is a common comorbidity in CHF patients and is associated with poorer prognosis [8]. Few studies regarding chronic kidney disease (CKD) and anemia have been conducted in patients with Chagas cardiomyopathy (CC). We evaluated the risk prediction performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and anemia in CC patients. CKD and anemia were not associated with all-cause mortality. When they coexisted, an additional risk was attributed for these patients. CKD and anemia are not independent predictors for long-term mortality in CC patients. The prognosis is poorer in individuals with both comorbidities
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
