CARDIORENAL CONTINUUM OR CARDIORENAL SYNDROME?


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Abstract

Purpose. Characterization of patients with chronic heart failure (CHF) associated with chronic kidney disease (CKD).
Materials and methods. Study enrolled 368 patients (187 men, 181 women) with II-IV FC CHF aged 18 - 84 years (mean age, 60 ± 10 years). The majority of patients - 247 (67%) had CHF with preserved ejection fraction. Glomerular filtration rate was calculated by MDRD formula, CKD diagnosed according to the NKF K/ DOQI, Guidelines, 2002.
Results. GFR was 68.8 ± 20.9 ml/min/1.73m2 (18.4 to 142.6 ml/min/1,73m2), whereas GFR <60 ml/min/1.73 m2 was observed in 136 (37%) patients. CHF preceded decrease in renal function in 72 (53%) patients; in 27 (20%) patients it was impossible to determine what came first - heart failure or renal dysfunction; in 7 (5%) patients renal dysfunction preceded the appearance of CHF. 42 patients had diabetes mellitus, therefore it was impossible to determine the causal relationship between heart failure and renal dysfunction.
Conclusion. Renal impairment occurs in one third of patients with CHF. In many cases, it is impossible to determine cause-effect relationship between the pathology of heart and kidney. The authors proposed own variant of classification, which in addition to acute and chronic cardiorenal syndrome and renokardial syndrome determine types of these syndromes: type 1 - the cause-effect relationships between the dysfunction of the heart and kidneys are defined, type 2 - it is unknown tat was the cause, and that a result.

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