Impact of chronic kidney disease on clinical, laboratory, and echocardiographic features in patients with heart failure
A Preveden, A Milovancev, M Belopavlovic, M Rodic, J Vidovic, N Okwose, A Fuller, M Jimenez Blanco Bravo, R Stefanetti, D Edwards, F Barlocco, L Maier, N Filipovic, D J Jakovljevic, L VelickiAbstract
Objective
To evaluate the impact of chronic kidney disease (CKD) on clinical presentation, laboratory parameters, electrocardiographic (ECG), and echocardiographic features in patients with chronic heart failure (CHF).
Methods
A retrospective cross sectional study included 2,227 patients hospitalized in a tertiary care center due to CHF. Patients were divided into two groups based on the presence of CKD, defined as eGFR < 60 ml/min/1.73 m². Demographic, clinical, laboratory, and echocardiographic data were collected for all patients. Comparative analyses were performed to assess differences in cardiovascular risk factors, comorbidities, laboratory parameters, and echocardiographic findings between the two groups.
Results
The proportion of men was significantly higher in the non-CKD group, whereas women predominated in the CKD group (p<0.001). Dyspnea, orthopnea, leg swelling, claudication, and expectoration were significantly more frequent in patients with CKD, while chest pain and palpitations were more common in the non-CKD group (all p<0.05). A significant difference in the distribution of NYHA functional classes was observed between the groups (p<0.001), with NYHA class IV being more prevalent in the CKD group and classes II and III more frequent in the non-CKD group. Levels of CRP and NT-proBNP were significantly higher in the CKD group (p<0.001). Sinus rhythm was more frequently observed in patients without CKD (p<0.001).
Conclusion
Coexistence of CKD was associated with a more severe clinical presentation, advanced functional limitation, and a distinct laboratory and echocardiographic profile in HF patients.Heart failure patients according to eGFRFor image description, please refer to the figure legend and surrounding text.