title: Impact of Cardiorenal Anemia Syndrome on Short- and Long-Term Clinical Outcomes in Patients Hospitalized with Heart Failure.
abstract: BACKGROUND
  Dysfunctional interplay between the heart and kidneys may lead to the development of anemia. The aim of this study was to evaluate the impact of cardiorenal anemia syndrome (CRAS) on short- and long-term outcomes among patients hospitalized with heart failure (HF).
  
  
  METHODS
  We enrolled 303 patients hospitalized with HF. We divided the patients into two groups: a CRAS group (n = 64) and a non-CRAS group (n = 239). We defined CRAS as HF accompanied by (1) an estimated glomerular filtration rate <60 ml/min/1.73 m(2) calculated by the Modification of Diet in Renal Disease at admission and (2) a hemoglobin level <12 g/dl for females and <13 g/dl for males at admission. The primary outcome was a composite of cardiac death, non-fatal myocardial infarction and rehospitalization for HF.
  
  
  RESULTS
  During a median follow-up period of 25.6 months (range 0.1-35.3 months), the patients with CRAS had a significantly increased risk for the primary outcome (27.5 vs. 10.7%, p < 0.001) compared with the patients in the non-CRAS group. Using Cox proportional hazard analyses, the hazard ratio (HR) for the presence of CRAS was found to be 1.874 (95% confidence interval [CI] 1.011-3.475, p = 0.046); HRs were also computed for the presence of diabetes mellitus (HR = 2.241, 95% CI 1.221-4.112, p = 0.009), New York Heart Association class III or IV HF (HR = 2.948, 95% CI 1.206-7.205, p = 0.018) and the use of intravenous loop diuretics (HR = 2.286, 95% CI 0.926-5.641, p = 0.073).
  
  
  CONCLUSIONS
  Renal dysfunction and anemia are a fatal combination and are associated with poor prognosis in patients with HF.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Daejon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
authors.forename: Chan Joon
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Inchon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Inchon, Republic of Korea.
authors.forename: Ik-Jun
authors.initials: IJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hun-Jun
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Pum-Joon
authors.initials: PJ
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kiyuk
authors.initials: K
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Sang Hong
authors.initials: SH
authors.lastname: Baek
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
keywords: Anemia; Heart failure; Prognosis; Renal failure