Bramania Puneet Kishore, Ruggajo Paschal Joseph, Furia Francis Fredrick
Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, United Republic of Tanzania.
Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania.
Egypt Heart J. 2021 Oct 30;73(1):97. doi: 10.1186/s43044-021-00223-z.
Heart failure among patients on hemodialysis therapy portends poor outcomes. Traditional risk factors like aging, hypertension and diabetes mellitus are relatively common in these patients and may not accurately predict the occurrence of heart failure. Such patients may have other factors that contribute to heart failure. This study aimed to investigate the prevalence and predictors of heart failure among patients on maintenance hemodialysis at Muhimbili National Hospital in Dar es Salaam, Tanzania.
Among 160 patients on maintenance hemodialysis, 49 (30.6%) were female. The mean age of patients was 52.2 ± 13.3 years. Almost all patients had hypertension and 69 (43.1%) had diabetes mellitus. Heart failure was prevalent in 17 (10.6%) patients. On multivariate analysis, presence of angina, intradialytic hypertension, and anemia were independent predictors of heart failure. Patients with heart failure had significantly higher malnutrition inflammation scores and erythropoietin resistance indexes.
Heart failure among hemodialysis patients correlates with the presence of angina, intradialytic hypertension, and anemia. Patients with heart failure had a greater degree of malnutrition-inflammation complex, and erythropoietin resistance. Patients with these conditions require a thorough cardiac evaluation and appropriate treatment.
接受血液透析治疗的患者发生心力衰竭预示着不良预后。衰老、高血压和糖尿病等传统风险因素在这些患者中相对常见,可能无法准确预测心力衰竭的发生。此类患者可能还有其他导致心力衰竭的因素。本研究旨在调查坦桑尼亚达累斯萨拉姆穆希姆比利国家医院维持性血液透析患者心力衰竭的患病率及预测因素。
在160例维持性血液透析患者中,49例(30.6%)为女性。患者的平均年龄为52.2±13.3岁。几乎所有患者都患有高血压,69例(43.1%)患有糖尿病。17例(10.6%)患者存在心力衰竭。多因素分析显示,心绞痛、透析中高血压和贫血是心力衰竭的独立预测因素。心力衰竭患者的营养不良炎症评分和促红细胞生成素抵抗指数显著更高。
血液透析患者的心力衰竭与心绞痛、透析中高血压和贫血有关。心力衰竭患者存在更严重的营养不良 - 炎症复合体和促红细胞生成素抵抗。患有这些病症的患者需要进行全面的心脏评估和适当治疗。