PS-C24-11: CLINICAL COURSE OF ACUTE DECOMPENSATED HEART FAILURE IN PATIENTS WITH RENAL DYSFUNCTION

Abstract

The aim of the work: To determine the influence of the presence of impaired renal function on the clinical course of the disease of acute decompensated heart failure. Materials and methods: The prospective study involved 72 patients with acute decompensated heart failure aged 48 to 82 years (mean age 68.4 ± 2.1), including 53 (73.6%) men, who were successively hospitalized in the cardiology department of the Oleksandrivska Clinical Hospital in Kyiv, Ukraine. Patients were divided into two groups depending on GFR at hospitalization: < 60 ml/h/1.73m2, i.e. significantly reduced, and < 60 ml/h/1.73m2, i.e. mildly to moderately decreased. The results: In the group with reduced GFR, patients were significantly older in age (63.7 ± 2.83 vs. 56.4 ± 2.48, p < 0.01) and differed in a higher frequency of hypertension (84.7% vs. 55.6%, p < 0.01), diabetes mellitus (30.6% vs. 15.3%, p < 0.05), a decrease in LVEF < 45% (88.9% vs. 69.4%, p < 0.01). The average time of hospital treatment was 14.7 ± 0.9 days in the GFR < 60 group, and 11.6 ± 0.5 days in the GFR < 60 ml/h/1.73m2 group, p < 0.01. A greater severity of HF according to NYHA classes with a predominance of IV FC in patients of this group was associated with a greater severity of clinical manifestations of congestion - shortness of breath according to the Borg scale, congestion index (all p < 0.05), as well as an increase in E/E‘ by 22.7% and NT-proBNP - by 24.2% (p < 0.01). Conclusions: In patients with acute decompensated heart failure, renal dysfunction is observed in 62,5% of cases and is associated with a more difficult clinical course of the inpatient treatment period, a higher frequency of arterial hypertension, more severe signs of congestion and the need for more aggressive decongestive treatment. An additional negative contribution is the development of acute kidney injury during the first 48 hours in a significant part of patients.