Key result
Moderate-to-severe kidney dysfunction is not linked to in-hospital death in hospitalized heart failure patients.
Why the study?
Kidney dysfunction is common in heart failure and associated with poor outcomes, but data on its prevalence, correlates, and prognosis in Cameroon were lacking.
Cross-Sectional (n=74)
No
Effect estimate: aOR 0.4 (95% CI 0.1-2)
In a Cameroonian cohort of hospitalized heart failure patients, moderate-to-severe kidney dysfunction was highly prevalent (50%) but was not the primary driver of in-hospital mortality.
High kidney dysfunction prevalence in HF without in-hospital mortality link should not change practice; leaves open its prognostic role in observational cohorts.
BACKGROUND: Kidney dysfunction is common in patients with heart failure (HF) and has been associated with poor outcomes. This study aimed to determine the prevalence, correlates, and prognosis of kidney dysfunction in patients with HF in Cameroon, an understudied population. METHODS: . Prognostic outcomes included death and prolonged hospital stay (> 7 days). We also performed a sensitivity analysis excluding racial considerations. RESULTS: Seventy four patients (86.1% of those eligible) were included. Their median age was 60 (interquartile range: 44-72) years and 46.0% (n = 34) were males. Half of patients (n = 37) had kidney dysfunction. Correlates of kidney dysfunction included previous diagnosis of HF (adjusted odds ratio [aOR]4.3, 95% CI: 1.1-17.5) and left ventricular hypertrophy (aOR3.4, 95% CI: 1.1-9.9). Thirty-six (48.9%) had prolonged hospital stay, and seven (9.5%) patients died in hospital. Kidney dysfunction was not associated with in-hospital death (aOR 0.4, 95% CI: 0.1-2) nor prolonged hospital stay (aOR 2.04, 0.8-5.3). In sensitivity analysis (excluding racial consideration), factors associated with Kidney dysfunction in HF were; anemia (aOR: 3.0, 95% CI: 1.1-8.5), chronic heart failure (aOR: 4.7, 95% CI: 0.9-24.6), heart rate on admission < 90 bpm (aOR: 3.4, 95% CI: 1.1-9.1), left atrial dilation (aOR: 3.2, 95% CI: 1.04-10), and hypertensive heart disease (aOR: 3.1, 95% CI: 1.2-8.4). Kidney dysfunction in HF was associated with hospital stay > 7 days (OR: 2.6, 95% CI: 1-6.8). CONCLUSION: Moderate-to-severe kidney dysfunction was seen in half of the patients hospitalized with HF in our setting, and this was associated with a previous diagnosis of HF and left ventricular hypertrophy. Kidney dysfunction might not be the main driver of poor HF outcomes in this population. In sensitivity analysis, this was associated with anemia, chronic heart failure, heart rate on admission less than 90 bpm, left atrial dilatation, and hypertensive heart disease. Kidney dysfunction was associated with hospital stay > 7 days.
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Jingi et al. (2022) conducted a cross-sectional in Heart failure (n=74). Kidney dysfunction (eGFR < 60 ml/min/1.73m2) vs. Normal or mildly impaired kidney function (eGFR ≥ 60 ml/min/1.73m2) was evaluated on In-hospital death (aOR 0.4, 95% CI 0.1-2). Moderate-to-severe kidney dysfunction was present in 50% of patients hospitalized with heart failure but was not significantly associated with in-hospital death (aOR 0.4).
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