Predictors of chronic heart failure development and progression in pre-dialysis patients with chronic kidney disease
Background. Chronic kidney disease leads to early damage to the heart and blood vessels with the development of heart failure. The manifestation of one disease leads to the progression of another, since chronic heart failure is a condition in which the myocardium and kidneys are pathogenetically closely related to each other. The purpose of the work was to identify early predictors of chronic heart failure development and progression in patients with chronic kidney disease. Materials and methods. A retrospective analysis of case histories of 322 patients with chronic kidney disease stages 1–4 was carried out. Patients were divided into two groups: the main group included those with chronic kidney disease and chronic heart failure (n = 50), the comparison group — patients with chronic kidney disease, but without chronic heart failure (n = 50). We studied the data of clinical, laboratory and instrumental examination. The obtained results were processed statistically. Results. Patients with chronic kidney disease and signs of heart failure had an increased body mass index, leg swelling, and stage 2 hypertension degrees 1–2. The electrocardiograpy revealed a rhythm disturbance by the type of paroxysmal tachycardia and atrial fibrillation. A decrease in hemoglobin level, filtration function of the kidneys, as well as manifestations of dyslipidemia were detected. Conclusions. Diastolic hypertension, anemia and increased total cholesterol can be considered as early predictors of chronic heart failure in patients with chronic kidney disease. Consequently, the risk of heart failure development and progression increases with a decrease in glomerular filtration rate below 60 ml/min. Chronic heart failure develops earlier and progresses faster in patients with chronic kidney disease that developed as a result of chronic glomerulonephritis.
Full Text:PDF (Українська)
Rashidi A, Sehgal AR, Rahman M, O'Connor AS. The case for chronic kidney disease, diabetes mellitus, and myocardial infarction being equivalent risk factors for cardiovascular mortality in patients older than 65 years. Am J Cardiol. 2008 Dec 15;102(12):1668-73. doi: 10.1016/j.amjcard.2008.07.060.
Dushina AG, Libis RA. New opportunities in treatment of chronic heart failure with normal ejection fraction. Cardiovascular Therapy and Prevention. 2015;14(4):52-58. doi: 10.15829/1728-8800-2015-4-52-58. (in Russian).
Rodionova VV, Khmel' ES, Turenko EA. The effect of comorbid pathology of the kidneys on the survival of patients suffering from chronic obstructive pulmonary disease. In: Abstracts of scientific reports of the Scientific-Practical Conference on the 100th anniversary of the birth of Professor Kryzhanovs'ka II on Current issues of internal medicine. 2013, May 15-16; Dnipro, Ukraine. Dnipro: Gerda; 2013. 146 р. (in Russian).
Hampl H, Hennig L, Rosenberger C, et al. Effects of optimised heart failure therapy and anemia correction with epoetin beta on left ventricular mass in hemodialysis patients. Am J Nephrol. 2005 May-Jun;25(3):211-20. doi: 10.1159/000085881.
Hayashi T, Suzuki A, Shoji T, et al. Cardiovascular effect of normalizing the hematocrit level during erythropoetin therapy in predialysis patients with chronic renal failure. Am J Kidney Dis. 2000 Feb;35(2):250-6.
Jin B, Luo X, Lin H, Li J, Shi H. A meta-analysis of erythropoiesis-stimulating agents in anaemic patients with chronic heart failure. Eur J Heart Fail. 2010 Mar;12(3):249-53. doi: 10.1093/eurjhf/hfp182.
Keane WF, Brenner BM, De Zeeuw D, et al. The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: the RENAAL study. Kidney Int. 2003 Apr;63(4):1499-507. doi: 10.1046/j.1523-1755.2003.00885.x.
Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013 Jul;34(28):2159-219. doi: 10.1093/eurheartj/eht151.
Nesen AO. Patogenetychni mehanizmy i diagnostychno-terapevtychna strategija pojednannja aterosklerozu i hronichnoi' hvoroby nyrok. Diss. kand. med. nauk [Pathogenetic mechanisms and therapeutic strategy of combining atherosclerosis and chronic kidney disease. PhD diss.]. Kharkiv; 2013. 39 p. (in Ukrainian).
Copyright (c) 2019 KIDNEYS
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2019