Prothasis Maria, Varma Anuj, Gaidhane Shilpa, Kumar Sunil, Khatib Nazli, Zahiruddin Quazi S, Gaidhane Abhay
Department of Medicine, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India.
Department of Physiology, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India.
J Family Med Prim Care. 2020 Aug 25;9(8):4127-4133. doi: 10.4103/jfmpc.jfmpc_533_20. eCollection 2020 Aug.
Heart failure leading to renal dysfunction and vice-versa termed as Cardio-Renal Syndrome(CRS) has now been increasingly identified as a marker of higher morbidity and mortality. Till date, there is limited data available regarding clinical profile, associated risk factors and outcome of CRS in rural population of central India. This study was conducted to elucidate the prevalence, risk factors, and outcome of CRS and its types.
This was a single-centric, cross-sectional study conducted amongst the patients admitted to medicine wards and ICCU from October 2017 to September 2019. Classification given by RONCO . in 2008 was used for classifying CRS patients into various types. Cross-sectional data was used to find the prevalence, risk factors and their inter-relationship with outcome and mortality. STATA software was used for statistical analysis.
Out of 96 CRS patients, 47(48.96%) were Type 1, 22 (22.92%) were type 2, 19(19.79%) were type 4 and 3 (3.13% ) were type 3, and 5 (5.21%) were of type 5. Most common risk factor was Hypertension (HTN) found in 46 (47.92%), followed closely by Coronary Artery Disease (CAD) and anaemia. Mortality was seen in 44(45.83%) of CRS patients and it was significantly high. High mortality was common in patients of types 3 and type 5 CRS. Risk factors like HTN, CAD, smoking, reduced glomerular filtration rate, low ejection fraction and sepsis were significantly associated with worse outcomes across all CRS sub-types.
There is high mortality among CRS. Prevention or optimal management of HTN, CAD and sepsis is required to decrease mortality. There is need for more population based studies for confirming our study findings.
导致肾功能不全的心力衰竭以及反之情况（即心肾综合征，CRS）如今已越来越多地被视为发病率和死亡率升高的一个标志。迄今为止，关于印度中部农村地区CRS的临床特征、相关危险因素及预后的可用数据有限。本研究旨在阐明CRS及其各类型的患病率、危险因素和预后情况。
这是一项单中心横断面研究，于2017年10月至2019年9月期间对入住内科病房和重症监护病房（ICCU）的患者进行。采用罗恩科（RONCO）在2008年给出的分类方法将CRS患者分为不同类型。横断面数据用于找出患病率、危险因素及其与预后和死亡率的相互关系。使用STATA软件进行统计分析。
在96例CRS患者中，47例（48.96%）为1型，22例（22.92%）为2型，19例（19.79%）为4型，3例（3.13%）为3型，5例（5.21%）为5型。最常见的危险因素是高血压（HTN），有46例（47.92%），紧随其后的是冠状动脉疾病（CAD）和贫血。44例（45.83%）CRS患者出现死亡，死亡率显著较高。3型和5型CRS患者中高死亡率较为常见。高血压、CAD、吸烟、肾小球滤过率降低、射血分数降低和脓毒症等危险因素在所有CRS亚型中均与更差的预后显著相关。
CRS患者死亡率较高。需要对高血压、CAD和脓毒症进行预防或优化管理以降低死亡率。需要开展更多基于人群的研究来证实我们的研究结果。
