Prevalence, correlates and in-hospital outcomes of kidney dysfunction in hospitalized patients with heart failure in Buea-Cameroon

BMC Nephrology

Ronald Gobina¹  Clovis Nkoke²  Denis Teuwafeu³  Cyrille Nkouonlack³  Jean Jacques Noubiap⁴  Anastase Dzudie⁵  Gloria Ashuntantang⁶  Ahmadou Musa Jingi⁶  Alex T. Mambap⁶  Debimeh Njume⁷ 

[1] Buea Regional Hospital, Buea, Cameroon;Buea Regional Hospital, Buea, Cameroon;Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon;Buea Regional Hospital, Buea, Cameroon;Faculty of Health Sciences, University of Buea, Buea, Cameroon;Center for Heart Rhythm Disorders, University of Adelaide, Adelaide, SA, Australia;Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon;Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaoundé, Cameroon;Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon;Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaoundé, Cameroon;

关键词: Kidney dysfunction;    Heart failure;    Outcome;    Mortality;    Cameroon;    Sub-Saharan Africa;   

DOI  :  10.1186/s12882-021-02641-2

来源: Springer

【 摘 要 】

BackgroundKidney dysfunction is common in patients with heart failure (HF) and has been associated with poor outcomes. This study aimed to determine the prevalence, correlates, and prognosis of kidney dysfunction in patients with HF in Cameroon, an understudied population.MethodsWe conducted a cross-sectional study in consecutive patients hospitalized with HF between June 2016 and November 2017 in the Buea Regional Hospital, Cameroon. Kidney dysfunction was defined as an estimated glomerular filtration rate < 60 ml/min/1.73m2. Prognostic outcomes included death and prolonged hospital stay (> 7 days). We also performed a sensitivity analysis excluding racial considerations.ResultsSeventy four patients (86.1% of those eligible) were included. Their median age was 60 (interquartile range: 44–72) years and 46.0% (n = 34) were males. Half of patients (n = 37) had kidney dysfunction. Correlates of kidney dysfunction included previous diagnosis of HF (adjusted odds ratio [aOR]4.3, 95% CI: 1.1–17.5) and left ventricular hypertrophy (aOR3.4, 95% CI: 1.1–9.9). Thirty-six (48.9%) had prolonged hospital stay, and seven (9.5%) patients died in hospital. Kidney dysfunction was not associated with in-hospital death (aOR 0.4, 95% CI: 0.1–2) nor prolonged hospital stay (aOR 2.04, 0.8–5.3). In sensitivity analysis (excluding racial consideration), factors associated with Kidney dysfunction in HF were; anemia (aOR: 3.0, 95% CI: 1.1–8.5), chronic heart failure (aOR: 4.7, 95% CI: 0.9–24.6), heart rate on admission < 90 bpm (aOR: 3.4, 95% CI: 1.1–9.1), left atrial dilation (aOR: 3.2, 95% CI: 1.04–10), and hypertensive heart disease (aOR: 3.1, 95% CI: 1.2–8.4). Kidney dysfunction in HF was associated with hospital stay > 7 days (OR: 2.6, 95% CI: 1–6.8).ConclusionModerate-to-severe kidney dysfunction was seen in half of the patients hospitalized with HF in our setting, and this was associated with a previous diagnosis of HF and left ventricular hypertrophy. Kidney dysfunction might not be the main driver of poor HF outcomes in this population. In sensitivity analysis, this was associated with anemia, chronic heart failure, heart rate on admission less than 90 bpm, left atrial dilatation, and hypertensive heart disease. Kidney dysfunction was associated with hospital stay > 7 days.

【 授权许可】

CC BY