| Background:In patients with chronic heart failure (CHF), kidney dysfuction was associated with increased morbidity and mortality.Unfortunately,we have no evidence from clinical heart failure trials on which to base about our therapy for patients with renal dysfunction.Therefore,It is ctritical to address preventing and treatment.This study aims to analyze the prevelance,clinical feature and drug treatment.What is more, we want clinical doctors especially experting on cardiology or nephrology to pay attention to the clinical feature and drug treatment of hospitalized chronic heart failure patients with renal dysfunction.Objective: To analyze the prevalence,clinical feature,and drug treatment of hospitalized chronic heart failure(CHF) patients with renal dysfunction.Methods:1153 cases with chronic heart failure were included in research from Red Cross Hospital of Guangzhou from January 2009 to June 2009.Clinical data were recorded including medical history,general case,physical examination,laboratory results,other assistant examination, medication use, hospital stay and so on. Modified glomerular filtration rate (GFR) Estimating Equation for Chinese Patients was used to evaluated the patients'renal function:c-aGFR (ml-min-1·1.73m-2)=186X [Pcr]-1.154X [age]-0.203X 1.233(female×0.742)(Pcr:mg/dl, 1mg/dl= 88.402umol/l).According to GFR,all the patients were divided into three groups:group A (GFR≥90ml-min-1·1.73m-2), group B(60≤GFR< 90ml·min-1·1.73m-2), group C(GFR< 60ml-min-1·1.73m-2).That was the normal renal function group, the mild renal fuction damage group, the renal dysfunction group,respectively.The incidence,clinical feature, drug treatment and the relationship between renal function and hospital stay were analyzed.Results:193 cases were enrolled.The median age of the patients was 75 years old.There were 93 males (48.2%) and 100 (51.8%) famales.63 CHF patients'(32.6%) renal function were normal,81 CHF patients (42.0%) had mild renal function damage,49 CHF patients(25.4%) had renal dysfunction.Compared with the normal renal function group and the mild renal function damage group,the CHF with renal dysfunction patients were elder,whose median age was 79 years old.The major etiology of CHF with renal dysfunction patients was caused by hypertension (32.7%)and cardiac function NYHAIV were more (P<0.01). The complication proportion of hypertension,diabetics, anemia and hyperuricemia was higher(P<0.01).The median hospital stay of CHF with renal dysfunction was 13 day and longest in the three group(P< 0.01). Among the three group of enrolled CHF patients, There was significant difference in laboratory examination,such as haemoglobin,serum sodium, serum potassium, serum total cholesterol, plasma creatinine, glomerular filtration rate, serum uric acid,urine protein, hypersensitive C-reactive protein (P<0.05). What's more, the CHF with renal dysfunction patients were lower in haemoglobin and glomerular filtration rate,while higher in serum uric acid, plasma creatinine, hypersensitive C-reactive protein (P<0.05). Among the enrolled CHF patients, the major medieation included diuretic(75.1%) (P< 0.01), calcium antagonist(72.0%)(P> 0.05), statins(69.9%)(P>0.05),β-blocker (61.1%) (P<0.01).However,the application ratio of digitalis and angiotensin-converting enzeny inhabitor (ACEI) was 10.4%(P>0.05),25.9%(P<0.01) respectively.Conclusion:The incidence rate of renal dysfunction was higher in hospitalized CHF patients, the CHF patients with renal dysfunction were elder, cardic function much worse and longer hospital stay. What's more, the CHF with renal dysfunction patients were lower in haemoglobin and glomerular filtration rate,while higher in serum uric acid, plasma creatinine, hypersensitive C-reactive protein.The complication proportion of hypertension,diabetics,anemia, hyperuricemia was common.The drugs such as diuretic, calcium antagonist, statins,β-blocker were the major therapy for the CHF patients.However,the application proportion of ACEI was lower than the guidelines. |
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