Pronóstico a 1año en pacientes con insuficiencia cardíaca y enfermedad renal crónica: diferencias en relación con el tipo de insuficiencia cardíaca y la gravedad de la insuficiencia renal

AIMS To analyze the differences in clinical characteristics, treatment and 1-year outcomes between patients with HFrEF, HFmrEF and HFpEF according to CKD stage (4-5 versus 1-3). METHODS We analyzed data from 2,245 patients with HF included between 2019 and 2024 by 68 specialized HF units. Clinical characteristics, treatment and 1-year mortality and HF hospitalization rates were compared in HFrEF, HFmrEF and HFpEF patients according to CKD stages4-5 versus 1-3. RESULTS Of the 2,245 patients, 54.2% were HFrEF, 12% HFmrEF and 33.8% HFpEF. CKD stages4-5 were present in 9.9% (8.9% of HFrEF, 11.5% of HFmrEF and 11.3% of HFpEF patients). Median age was 73years (IQR: 63-80), being older in CKD 4-5 stages, and 37.3% were female. CKD 4-5 patients received in significantly lower proportion ARNI, MRA, betablockers and SGLT2i in HFrEF and HFmrEF. One-year mortality and 1-year rate of HF hospitalizations were significantly higher in patients with HFrEF and lower in those with HFmrEF and HFpEF in cases of CKD 4-5, but there were no differences among the three types of HF in the CKD 1-3 subgroup. There was significant interaction between ERC severity and HF subtypes (P=.025 for mortality and P=.046 for HF hospitalizations). CONCLUSIONS In this contemporary cohort of patients with HF, an association between renal dysfunction and type of HF was observed in terms of 1-year outcomes, with significant differences in event rates between HF types only in cases of more severe CKD.