The prevalence of renal disease in patients with decompensation of chronic heart failure

Purpose. The evaluation of the prevalence of renal disease in patients with CD in the Russian population according to the two registers, ORACLE-RF and Pavlovsk register. Material and methods. Pavlovsk register was formed in 2ОО9. The register includes 1ОО1 patients with decompensated heart failure. The follow-up period for the included patients was 30, 90, 180, and З60 days after discharge. ORACLE-RF register was formed in 41 centers of the 20 cities of the Russian Federation (2010-2011). Data for 2404 patients were available for final analysis. 94 patients were lost to follow-up in the post-hospital period . Statistical analysis was performed using Statistica 6.1 and 10 software. Results. Analysis of ORACLE-RF register showed that only 16% of patients had a GFR> 90 mL/min/1.73 m 2, and 28 and 33% could be classified as 1st and 2nd stage CKD, respectively. In the group of stage 1 CKD, albuminuria A1 level was 9%, albuminuria A2 level - 2. In the group of stage 2 CKD, albuminuria A1 level was 11%, A2 - 6%, A3 - 4%. Analysis of Pavlovsk register showed that 47% of the included patients had GFR> 60 mL/min/1.73 m 2, of which only 6% had albuminuria levels A1 and 14% - albuminuria A2 level; contracted kidney confirmed by ultrasound was revealed in 12%. 52% of patients had GFR <60 ml/ min/ 1.73 m 2, with GFR <30 ml/ min /1.73 m 2 in 14% of patients included in the register, and only 1% of patients had GFR <15 ml / min / 1.73 m 2. Arteriosclerotic contracted kidney was diagnosed in patients with GFR> 60 ml / min / 1.73 m 2 in 20% of cases, and in patients with GFR <30 ml / min / 1.73 m 2 - in 13% of cases. When comparing the registers, one of the most significant differences was mortality rate among patients with GFR <60 ml / min / 1.73 m 2. In the Pavlovsk register, GFR has a significant impact on the mortality of patients, whereas in the ORACLE-RF register GFR has no effect on mortality. In ORACLE-RF register, increased creatinine or urea levels had no direct significant effect on mortality, despite the fact that the presence of CKD significantly increased mortality, OR was 3.82 (95% Cl, 3.37-4.33). Conclusions. As a result of the comparative analysis of the two Russian registers on decompensation of heart failure, it was found that the prevalence of CKD is large enough, and Pavlovsk register contains the largest number of patients with CHF and CKD.

crd, decompensation of CHF, GFR, albuminuria