Type 1 Cardiorenal Syndrome in Decompensated Heart Failure Patients in a Low-Income Region in Brazil: Incidence of Acute Kidney Injury (AKIN and KDIGO Criteria), Need for Dialysis and Mortality

• Published in: Arquivos brasileiros de cardiologia 2021-01, Vol.117 (2), p.385-391
• Main Authors: Nascimento, Ginivaldo Victor Ribeiro do, Brito, Heitor Carlos Domingues de, Lima, Carlos Eduardo Batista de
• Format: Article
• Language: eng ; por
• ISSN: 1678-4170
• DOI: 10.36660/abc.20200097

BACKGROUNDType 1 cardiorenal syndrome is associated with higher mortality in heart failure patients. However, few studies have compared the diagnostic criteria of acute kidney injury (AKI) in this population. OBJECTIVETo assess clinical and functional features and factors associated AKI in patients with heart failure. METHODRetrospective, cohort study on patients with decompensated heart failure or recent acute myocardial infarction, conducted in a tertiary hospital in a low-income region of Brazil. Clinical, laboratory and echocardiographic features were compared between patients with and without AKI according to the Acute Kidney Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO) criteria. The level of statistical significance was set at p < 0.05. RESULTSOf 81 patients, 61.73% had AKI. Mean creatinine and urea levels were 1.79±1.0 mg/dL and 81.5±46.0 mg/dL, respectively, and higher in the group with AKI (p < 0.05). No evidence of a relationship between cardiac changes and reduced renal function. Chronic renal disease was associated with higher prevalence of AKI. Higher mortality was observed in patients with AKI than in patients without AKI (32.0% vs. 9.8%, p = 0.04, OR 8.187 ad 95% confidence interval 1.402-17.190, p = 0.020). CONCLUSIONIn this population of patients with heart failure, AKI was highly prevalent and considered an independent risk factor for mortality. Cardiac changes were not associated with AKI, and the KDIGO and AKIN criteria showed similar performance.