Worsening renal function in patients hospitalized with acutely decompensated heart failure

Marko  Lazović; Sonja Radenković; Dijana  Stojanović; Jelena Radović; Miodrag  Stojanović; Danijela Tasić; Dragana Stanojević

doi:10.2298/VSP170226038L

Marko Lazović Clinical Center Niš, Clinic for Cardiology, Niš, Serbia
Sonja Radenković Clinical Center Niš, Clinic for Nephrology Dialysis and Transplantation, Niš, Serbia
Dijana Stojanović University of Niš, Faculty of Medicine, Institute of Pathophysiology, Niš, Serbia
Jelena Radović University of Niš, Faculty of Medicine, Institute of Pathophysiology, Niš, Serbia
Miodrag Stojanović Institute for Public Health, Niš, Serbia
Danijela Tasić Clinical Center Niš, Clinic for Nephrology Dialysis and Transplantation, Niš, Serbia
Dragana Stanojević Clinical Center Niš, Clinic for Cardiology, Niš, Serbia

DOI: https://doi.org/10.2298/VSP170226038L

Ključne reči: srce, insuficijencija;, sindrom, kardio-renalni;, faktori rizika.

Sažetak

Uvod/Cilj. Bubrežna disfunkcija se često javlja kod bolesnika sa srčanom slabošću, predstavlja loš prognostički faktor i povezana je sa porastom mortaliteta kod ovih bolesnika. Cilj istraživanja je bio da se utvrde faktori rizika povezani sa razvojem bubrežne disfunkcije kod bolesnika sa akutnom dekompenzacijom srčane slabosti. Metode. Istraživanjem je obuhvaćeno 330 bolesnika sa akutnom dekompenzacijom srčane slabosti. Bolesnici koji su razvili bubrežnu disfunkciju (n = 215 ispitanika, starosti 72,4 ± 9,8 godina) činili su kliničku grupu, a bolesnici bez bubrežne disfunkcije (n = 115 ispitanika, starosti 59,8 ±11,7 godina) bili su kontrolna grupa. Kod ispitanika kliničke grupe analizirani su sledeći parametri: godine starosti, pol, lipidni status, koncentracija elektrolita u plazmi, prisustvo pušenja i hipertenzije i tip srčane slabosti. Korišćena je logistička regresija za izračunavanje odds ratio (OR) i 95% intervala poverenja za razvoj bubrežne disfunkcije kod ovih bolesnika. Rezultati. Bubrežna disfunkcija je ustanovljena kod 65,2% bolesnika sa srčanom slabošću. Pokazano je da su se kao značajni faktori rizika od razvoja bubrežne disfunkcije izdvojili starost ispitanika (OR = 1,6; p < 0,05), porast koncentracije ukupnog holesterola, > 5,2 mmol/L (OR = 1,6; p < 0,05), hiponatrijemija, < 135 mmol/L, (OR = 2,8; p < 0,01), pušenje (OR = 3,9; p < 0,01), hipertenzija (OR = 2,0; p < 0,05) i postojanje srčane slabosti sa smanjenom ejekcionom frakcijom (OR = 1,3; p < 0,01). Srčana slabost sa očuvanom ejekcionom frakcijom, hipokalijemija, < 3,5 mmol/L, visoka koncentracija triglicerida u plazmi, > 1,7 mmol/L i pol ispitanika nisu pokazali statistički značaj za razvoj bubrežne disfunkcije. Zaključak. Godine starosti, povišene vrednosti totalnog holesterola, hiponatrijemija, pušenje, hipertenzija i smanjenje ejekcione frakcije značajni su i nezavisni faktori rizika od razvoja bubrežne disfunkcije kod bolesnika sa srčanom slabošću. Poređenjem prediktivnih vrednosti, godine starosti bi mogle da budu najznačajniji faktor rizika za ranu identifikaciju bolesnika koji su pod povećanim rizikom od razvoja bubrežnog oštećenja.

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Bubrežna disfunkcija kod bolesnika sa akutnom dekompenzacijom srčane slabosti

Sažetak

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