title: Importance of anemia in the chronic Cardiorenal syndrome: effects on renal function after heart transplantation.
abstract: BACKGROUND
  Cardiorenal syndrome has been recently divided into 5 categories, according to acute or chronic evolution and primary organ dysfunction. Anemia can also accompany this disorder, leading to a more complex situation. This study aims to analyze the renal outcomes of patients, specifically patients with chronic Cardiorenal syndrome, with or without anemia, long-term after heart transplantation.
  
  
  METHODS
  This was a retrospective cohort study on chronic Cardiorenal syndrome patients submitted to heart transplantation. Patients were divided according to presence of anemia and renal dysfunction before heart transplantation.
  
  
  RESULTS
  A total of 108 patients (92 males) with the mean age of 45±12 years were included. The etiologies of the heart failure were hypertensive dilated myocardiopathy (66%), ischemic (14%) and Chagasic (12%). Before the heart transplantation, 51 patients had an eGFR less than 60 mL/min. From these, 24 had concomitant anemia. One year after the transplantation, patients with previous isolated renal dysfunction ameliorates eGFR (45±11 vs. 65±26 mL/min, p<0.001), while those patients with previous renal dysfunction and anemia presented no improvement (eGFR 44±14 vs. 47±13 mL/min, p=0.619) 1 year after heart transplantation. Moreover, higher hemoglobin was an independent predictor of eGFR improvement after heart transplantation when associated with previous renal dysfunction (OR 1.8; CI 1.2-3.6, p<0.01 for each hemoglobin increment of 1 g/dL).
  
  
  CONCLUSIONS
  Patients with isolated Cardiorenal syndrome presented partial renal function recovery after heart transplantation, while the presence of cardiorenal anemia was a marker of renal function non-recovery 1 year after heart transplantation.
authors.affiliation: Public Health Post-graduate Program, Universidade de Fortaleza (Unifor), Fortaleza, Ceará, Brazil.
authors.forename: Alexandre Braga
authors.initials: AB
authors.lastname: Libório
authors.forename: Russian Soares
authors.initials: RS
authors.lastname: Uchia
authors.forename: Alessa Peixoto
authors.initials: AP
authors.lastname: Aragao
authors.forename: João David de Sousa
authors.initials: JD
authors.lastname: Neto
authors.forename: Juan Miguel Cosquillo
authors.initials: JM
authors.lastname: Valdivia
authors.forename: Filipe
authors.initials: F
authors.lastname: de Alencar
authors.forename: Ricardo Everton Dias
authors.initials: RE
authors.lastname: Mont'Alverne
authors.forename: Francisco Ivan Benício
authors.initials: FI
authors.lastname: de Sá Filho
authors.forename: Juan Alberto Cosquillo
authors.initials: JA
authors.lastname: Mejia
mesh_terms: D000740:Anemia / Q000150:complications* / Q000503:physiopathology*; D059347:Cardio-Renal Syndrome / Q000150:complications* / Q000503:physiopathology*; D002908:Chronic Disease; D005260:Female; D005919:Glomerular Filtration Rate; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged