STUDY OF CLINICAL PROFILE AND OUTCOME OF TYPE 1CARDIORENAL SYNDROME AMONG HEART FAILURE PATIENTS IN A TERTIARY CARE HOSPITAL

Dr. Dharam Dev, Dr. Dalip Gupta, Dr. Neeraj Ganju and Dr. Ashish Kumar*

ABSTRACT

Background: The most common presenting symptom for acute heart failure is shortness of breath and infections are most common precipitating events for failure. Patients of cardiorenal syndrome type 1 had comparatively higher mortality and morbidity among acute heart failure patients. Aim of this study is to determine the clinical profile and outcome of type 1cardiorenal syndrome among heart failure patients. Material and Methods: Total 92 patients of acute heart failure were included in the study. The clinical and laboratory profile and course in hospital were documented. Results: Cardiorenal Syndrome Type 1 was present in 16.3% patients. In our study, out of 15 CRS1 patients, 9(60%) were females and 6(40%) were males. Whereas other studies showed predominantly male sex involvement in CRS1. Highest number of patients 23 each (25.00%) were between 51-70 years of age. At presentation the main underlying predisposing factors for acute heart failure in patients were DCMP in 4.34% (P value - 0.001), Smoking in Twenty one 22.82%, Hypertension in 27.17% and Diabetes Mellitus in Twenty 21.73% patients. Various precipitating events were present for acute decompensation of stable heart failure or for acute heart failure. Among total 92 patients, infection in 43.47%, non compliance to treatment in 6.52%, natural progression of disease in 13.04%, anemia in 5.43%, ACS in 17.39%. TShe main underlying etiologies for acute heart failure were CAD, ACS in 13.33%, RHD in 13.33%, DCMP in 40% (P value- 0.043), High output failure and Diabetic cardiomyopathy in13.33 % each. Among patients of CRS1, 73.3 % had stage 1 acute kidney injury, 20 % had stage 2 acute kidney injury whereas 6.7 % had stage 3 acute kidney injury. Among CRS1 patients 20 % patients had inhospital mortality and6.6% patients were given dialysis support. 80% patients impoved and discharged from hospital. Average length of stay of patients among CRS1 group was higher compared toNCRS1 group (P value - <0.0001). Conclusion: The patients of Type 1 CRS are seen predominantly in females and elderly populations. Most of the patients have stage 1 AKI and recovered completely. Thus it is concluded that patients of type 1 CRS are associated with more mortality and more duration of hospital stay and DCMP is important underlying cause for development of CRS1.

Keywords: Cardiorenal syndrome, non cardiorenal syndrome, acute kidney injury, dilated cardiomyopathy, acute heart failure.