Prevalance of anemia and its association with cardio-renal syndrome.
BACKGROUND
Anemia is common in cardio-renal syndrome and may contribute to increase mortality.


OBJECTIVE
To examine the prevalence of anemia and its relationship with cardio-renal syndrome, and to evaluate the risk factors for death.


METHODS
Retrospective study with all patients admitted with congestive heart failure (CHF). The parameters as age, gender, hemoglobin (Hb), estimated glomerular filtration rate (eGFR), New York Heart Association (NYHA) functional class, ejection fraction (EF%), hospital stay, hypertension, diabetes, smoking and CHF etiology were analyzed. Anemia was defined as Hb<12 g/dL, systolic dysfunction EF<55% and renal failure was stratified according to K-DOQI classification. Statistical analysis was done by the programs EpiInfo and SPSS for windows.


RESULTS
A total of 174 patients were studied. The average age was 63+/-16 years, 65.5% were males, and 18 of them (11%) were non-survivors. Anemia was observed in 45% of patients, and 82% presented some degree of renal failure. The majority of patients (87%) were classified as NYHA functional class III or IV. The average ejection fraction was 43.9+/-16.6%, and there was no difference between survivors and non-survivors (p>0.05). Mortality was not significantly higher among patients with anemia (12.4%) when comparing to those without anemia (8.3%, p=0.31). There was a progressive decrease in the level of hemoglobin as renal function decreased (p<0.05). Increased serum creatinine was a significant risk factor for death (OR=1.59, 95% CI=1.074-2.363, p=0.021), and increased EF% was a protection factor against development of death (OR=0.904, 95% CI=0.845-0.973, p=0.007).


CONCLUSIONS
The prevalence of anemia is high among patients with cardio-renal syndrome but was not associated with increased mortality. Increased serum creatinine and low EF% were variables associated with death.
Silva
Ricardo P
RP
Division of Cardiology, Hospital Universitário Walter Cantídio, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil. ricardops@secrel.com.br
Barbosa
Paulo H U
PH
Kimura
Osamu S
OS
Sobrinho
Carlos Roberto M R
CR
Sousa Neto
João David
JD
Silva
Frederico A L
FA
Silva Júnior
Geraldo B
GB
Mota
Rosa M S
RM
Daher
Elizabeth F
EF
D000368:Aged; D000740:Anemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D001938:Brazil / Q000453:epidemiology; D003404:Creatinine / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013577:Syndrome
D006454:Hemoglobins; D003404:Creatinine