Key result
Concurrent AKI and cardiohepatic syndrome in decompensated HF linked to ~2 extra hospital days.
Observational (n=322)
Concurrent acute kidney injury and cardiohepatic syndrome occurs in approximately 20% of patients with decompensated heart failure and is associated with worse hypoperfusion, congestion, and longer hospital stays.
Concurrent kidney-liver dysfunction may flag higher risk in decompensated HF; leaves open whether targeted interventions improve outcomes.
AIM: To study the incidence, pattern, and predictive factors of concurrent kidney and liver dysfunctions in patients with decompensated heart failure (HF). SUBJECTS AND METHODS: The kidney and liver function indicators were estimated in 322 patients aged 69.5±10.6 years with decompensated HF (hypertension in 87%, myocardial infarction in 57%, atrial fibrillation in 65%, chronic kidney disease in 39%, type 2 diabetes in 42%, a left ventricular ejection fraction (EF) of 38±13%, EF <35% 39%, NYHA Functional Class IV in 56%). Cardiohepatic syndrome (CHS) was diagnosed if at least one indicator of liver function was increased; acute kidney injury (AKI) was diagnosed using the KDIGO criteria. RESULTS: AKI and CHS had been previously diagnosed in 60 (18.6%) and 274 (85.1%) patients, respectively. Among the patients with signs of kidney and/or liver dysfunction, the incidence of isolated CHS, concurrent AKI and CHS, and isolated AKI was 78.4, 20.1, and 1.5%, respectively. The patients with concurrent kidney and liver dysfunctions were observed to have more profound systemic hemodynamic changes (hypoperfusion and congestion). The risk of concurrent AKI and CHS increased glomerular filtration rate (GFR) <45 ml/min/1.73 m2, admission systolic blood pressure <110 mm Hg, needs for vasopressors, hydropericardium, and EF <35%. The concurrence of AKI and CHS was associated with longer hospital stay (15.7±6.5 and 13.5±4.8 days, respectively; p<0.05). CONCLUSION: The incidence of concurrent AKI and CHS in patients with decompensated HF is 20.1%. Concurrent kidney and liver dysfunctions is associated with more obvious signs of hypoperfusion and congestion and characterized by worse prognosis.
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Villevalde et al. (2016) conducted an observational in Decompensated heart failure (n=322). Concurrent acute kidney injury (AKI) and cardiohepatic syndrome (CHS) vs. Without concurrent AKI and CHS was evaluated on Hospital stay duration (days) (p=<0.05). Concurrent acute kidney injury and cardiohepatic syndrome occurred in 20.1% of patients with decompensated heart failure and was associated with a longer hospital stay (15.7 vs 13.5 days; p<0.05).
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