The relationship between the severity of heart failure and the severity of renal dysfunction: evidence from South Africa (Preprint)

BACKGROUND In sub-Saharan Africa, although the rate of heart failure (HF) is rising, there is a lack of local data assessing the relationship between heart failure and renal dysfunction. OBJECTIVE The primary aim of this study was to assess the relationship between the severity of heart failure and the severity of renal dysfunction METHODS A single-centre retrospective study was conducted of patients attending the Heart Failure Clinic at Charlotte Maxeke Johannesburg Academic Hospital. The patient files were analysed specifically for the presence of renal dysfunction, ejection fraction, blood pressure, New York Heart Association (NYHA) functional class, furosemide (Lasix) dose, six-minute walk test distance, and Minnesota Living with Heart Failure Questionnaire score. A total of 242 files were reviewed, of which 42 were excluded because of inadequate data recorded in the file, leaving 200 files for analysis RESULTS The mean estimated glomerular filtration rate (eGFR) was 72.01 mL/min/1.73 m2. The overall prevalence of a low eGFR (<60 mL/min/1.73 m2) in the sample was 34.5%, and the sex-specific prevalence was comparable in women (35.4%) and men (33.7%). Minnesota Living with Heart Failure Questionnaire score, six-minute walk test distance, diastolic blood pressure, furosemide dose and age were each significantly correlated with eGFR (p<0.05). CONCLUSIONS The results indicate that cardiorenal syndrome was prevalent in this local cohort of HF patients. The study calls for urgent interventions such as early diagnosis, advanced treatment and prevention.