Analysis Of Relevant Risk Factors For Renal Insufficiency In Patients With Chronic Heart Failure

Objective: The aim of this study was to explore the risk factors of renal insufficiency in patients with chronic heart failure by analyzing the clinical features of chronic heart failure patients with renal dysfunction.Methods: Applying retrospective method to describe the incidence of chronic heart failure patients with renal dysfunction.The study participants consisted of 211 males and 174 females with a mean age of 69.62±8.59 years.According to estimated glomerular filtration rate(e GFR),385 patients with chronic heart failure who were hospitalized in the First Affiliated Hospital of Shihezi University Medical College from January 2014 to August 2016 were divided into renal dysfunction group(e GFR<60ml·min-1·1.73m-2)and non renal dysfunction group(e GFR≥60ml·min-1·1.73m-2),which comparing the difference between two groups in general information,basic heart disease,concomitant disease,contrast agent application history,echocardiographic parameters,renal function indexes,blood lipids,N-terminal pro-brain natriuretic peptide(NT-pro BNP),hemoglobin,albumin and other laboratory examination results,to explore the possible risk factors of renal insufficiency in patients with chronic heart failure.Results: The incidence of renal insufficiency was 42.1% in 385 patients with chronic heart failure.Between renal insufficiency group and non renal insufficiency group,the differences of age,NYHA heart function classification,hypertension,diabetes,anemia,atrial fibrillation were statistically significant(P<0.05).The levels of serum creatinine,urea nitrogen,uric acid,cystatin C,NT-pro BNP and application of diuretics in renal insufficiency group were higher than those in non renal insufficiency group,and left ventricular ejection fraction,hemoglobin level and application of ACEIs were lower than those in non renal insufficiency group(P<0.05).Simple factor logistic regression analysis showed that age,NYHA heart function classification,hypertension,diabetes,anemia,the levels of serum creatinine,urea nitrogen,uric acid,cystatin C,NT-pro BNP and application of diuretics were risk factors of renal insufficiency in patients with chronic heart failure.Multivariate logistic regression analysis showed that age(OR 1.454,95%CI 1.099~1.925),NYHA heart function classification(OR 1.940,95%CI1.142~3.295),hypertension(OR 1.617,95%CI 1.009~2.591),anemia(OR 1.903,95%CI1.151~3.145),the high levels of serum urea nitrogen(OR 2.130,95%CI 1.266~3.584),cystatin C(OR 2.306,95%CI 1.262~4.214)and application of diuretics(OR2.433,95%CI 1.042~5.679)were independently associated with renal insufficiency.Conclusions: The incidence of renal insufficiency was higher in patients with chronic heart failure.The elder age,NYHA heart function Ⅳ classification,hypertension,anemia,the high levels of serum urea nitrogen and cystatin C as well as application of diuretics were independent risk factors of chronic heart failure patients with renal insufficiency.