Analysis of renal function and its effect on clinical prognosis in 139 patients with heart failure

doi:10.3969/j.issn.1672-5301.2017.08.009

Abstract：Objective To observe the renal function and its effect on clinical prognosis in patients with heart failure(HF).Methods Total 139 patients admitted in our hospital from September 2009 to September 2011 were divided into New York Heart Association (NYHA) class Ⅰ group (40 cases),class Ⅱ group (37 cases),class Ⅲ group(34 cases) and class Ⅳ group(28 cases).The serum levels of blood urea nitrogen(BUN),creatinine(Cr),uric acid (UA),as well as estimated glomerular filtration rate(eGFR) according to modified MDRD equation were measured.The left ventricular ejection fraction (LVEF) was determined by Doppler spectrum analysis.Results The mean age of patients above class Ⅱ] is significantly higher than that of patients in class Ⅰ.The average LVEF significantly decreased in patients with a higher class of NYHA.The levels of BUN,Cr and UA significantly increased in patients with a higher class than that in patients with class Ⅰ.Contrarily,the average eGFR remarkably decreased in patients of class Ⅳ than that in patients with a lower class.Total 96 patients of cardiorenal syndrome (CRS) were divided into mild renal insufficiency(RI) group and moderate-severe RI group.The percent of patients of class Ⅳ in moderate-severe RI group is significantly higher than that in mild RI group,while the percent of patients of class Ⅰ in moderate-severe RI group is remarkably lower.Compared the clinical prognosis,the mortality in moderate-severe RI group is highest in two year follow-up.Conclusion Patients complicated with CRS has a high incidence in heart failure.Those patients with worsening renal function have a poor outcome.It is important to protect renal function when to treat patients with heart failure above class Ⅱ of NYHA.