Abstract
BACKGROUND: Studies have identified abnormal renal function as one of the most important risk factors for morbidity and mortality in patients with heart failure (HF).OBJECTIVES: To determine the prevalence, mortality rate and factors associated with impaired kidney function (IKF) in patients admitted with HF.METHOD: Case notes, admission and discharge records of all patients admitted with a principal diagnosis of HF between January 2007 and January 2008 were studied. IKF was defined as serum creatinine e 124µmol/l for women and e 133µmol/l for men. Chronic kidney disease was defined as eGFR <60 mL/min or presence of markers of kidney disease for 3 months or more. RESULT: A total of ninety two patients were admitted for HF. Forty four (47.3%) had IKF. 19(20.7%) had renal failure. Twenty three of the patients (12 with IKF) died giving a mortality of 25%. SBP r=0.318, p=0.002, DBP, r=0.279,p=0.007, Serum Creatinine ,r=0.572,p< 0.001, correlated positively with presence of IKF. There were negative correlation between the presence of IKF and haemoglobin level(r=-0.513, p<0.001) and eGFR(r=-0.840, p<0.001). Linear regression analysis confirmed the eGFR (82%) as the best predictor of IKF. Renal failure appeared not to be independently associated with death among the heart failure patients. CONCLUSION: The prevalence and mortality of IKF in our patients with heart failure is high, 47.3% and 25% respectively. Up to 20.7% were already in kidney failure. It is important that the eGFR of our patients with HF be determined as a guide to identifying those with IKF. Efforts should be intensified at prevention, identification, and appropriate management of hypertension and anaemia in these patients.
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