Development of a prognostic score in patients with chronic cardiorenal syndrome

Česká verzia

Authors: F. Málek ¹; M. Havrda ²; L. Dobrovodská ¹; Z. Frühaufová ²; M. Lapšová ²
Authors place of work: 3. LF UK Praha ¹; Nefrologické oddělení, I. interní klinika FN KV a 3. LF UK Praha ²
Published in the journal: Kardiol Rev Int Med 2009, 11(3): 108-110
Category: Nontraditional risk factors cardiovascular disease

Summary

A prognostic score was established from seven independent prognostic parameters pertinent to patients with chronic heart failure (CHF) and impaired renal function. These parameters were: estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LV EF), left atrial index (LAi), estimated pulmonary artery pressure (ePAP), haemoglobin level (Hb), albumin concentration (alb) and furosemide daily dose (FSM). Each parameter was evaluated on a 4-point numerical scale and the overall score was calculated as a sum of all parameters. The aim of the study was to evaluate changes to the prognostic risk score over time in 20 patients with chronic cardiorenal syndrome (CRS), LV EF < 45%, eGFR < 1.0 ml/sec/1.73 sqm. Retrospective analysis of the prognostic parameters at the first (V1), follow‑up (V2) and the most recent (V3) clinic visits was performed. The risk score was calculated and the differences assessed with the statistical t‑test. The mean follow‑up between V1 and V3 was 474 ± 169 days. There was a significant risk score change between V1 and V2 (from 18.25 to 16.55, p = 0.007). Among the individual parameters, there was a significant change in ePAP only (from 49 to 37.5 mmHg, p < 0.01). The score and ePAP changed significantly between V1 and V3 too (from 18.25 to 15.25, p < 0.001 and from 49 to 31.25 mmHg, p < 0.001, respectively). Neither mean LV EF (36.7% to 45.25%), nor eGFR (0.48 to 0.51 ml/sec, p = 0.076 and p = 0.61, respectively) changed significantly between V1 and V3. The prognostic score in patients with chronic CRS significantly decreased during the short‑term follow‑up. Preliminary results should be confirmed in a larger patient population during a long‑term follow‑up.

Keywords:
cardiorenal syndrome – heart failure – renal insufficiency – prognostic parameters

Zdroje

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