The impact of chronic kidney disease on the annual prognosis in patients 80+ years old suffering from chronic heart failure.
BACKGROUND
It is well known that the function of kidneys is impaired with age.


OBJECTIVE
The purpose of the study was to evaluate whether chronic kidney disease (CKD) is a predictor for 1-year follow-up mortality among hospitalized chronic heart failure (CHF) patients aged 80+.


METHODS
The study included 141 consecutive patients aged 80-92 (mean: 82.4 years, 44.7% men). The prospective analysis contains 61 variables with glomerular filtration rate (GFR) and the occurrence of death at the 1-year follow-up. Patients were divided and analyzed depending on GFR.


RESULTS
Chronic kidney disease defined as estimated GFR < 60 ml/min/1.73 m(2) was recorded in 93 patients (66%). A relationship with GFR < 60 was found for older age (p = 0.0001), lower body mass index - BMI (p = 0.003), more advanced NYHA class III (p = 0.007), higher concentrations of N-terminal probrain natriuretic peptide - NT-proBNP (p = 0.023), lower hemoglobin (p = 0.0004) and LVEF (p = 0.005), longer hospitalization (p = 0.005), more frequent ventricular blocks in ECG (p = 0.017) and rarely performed coronary angiography (p = 0.021). In turn, GFR < 30 ml/min/1.73 m(2) was recorded in 14 patients (9.9%). Similar relationships as in GFR < 60 were found for GFR < 30 and additionally higher concentrations of high-sensitivity C-reactive protein (hsCRP) (p = 0.003), D-dimer (p = 0.002) and more frequent dyslipidemia (p = 0.004) and left main coronary artery disease (p = 0.007). Annual mortality for the total population was 14.2% (n = 20) and was higher (16.1%) if GFR was < 60 and even more (21.4%) in GFR < 30. However, the relationship between deaths and GFR was not statistically significant (for GFR < 60, p = 0.505 and GFR < 30, p = 0.547).


CONCLUSIONS
Annual mortality in the patients 80+ who suffered from CHF was high but not statistically significantly associated with CKD.
Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland.
Anna
A
Cichocka-Radwan
Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland.
Tomasz
T
Ciurus
Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland.
Malgorzata
M
Lelonek
chronic kidney disease; elderly; heart failure; prognosis