Evaluate Renal Function Of Chronic Heart Failure Paitients Whoses Creatinine Are Normal

Objective: Calculate Glomerular filtration rate(eGFR) of Chronic heart failure (CHF) patients with normal creatinine,to study the morbidity of renal insufficiency. Observe the correlation between NT-proBNP and creatinine, eGFR, left atrial dimension (LAD), left ventricular end- diastolic dimension(LVEDD), interventricular septum thick(IVST), Left ventricular ejection fraction(LVEF).Methods: The subjects of this study are 83 cases CHF patients with normal Cre and 20cases healthy check-up. According eGFR the CHF group were devided into: renal normal group(eGFR>80ml/min), renal compensation group(60 ml/min≤eGFR≤80ml/min), renal decompensation group(eGFR<60ml/min). Fasting critinine ,total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high- density lipoprotein cholesterol (HDL-C) , LAD, LVEDD, IVST, LVEF were measured in each patient, CHF group patients measured NT-proBNP.Results: (1) The level of ALT, AST, LAD, LVEDD, IVST, Cre in CHF group were significantly higher than that in normal control group and the level of eGFR, LVEF in CHF group were significantly lower than that in normal control group(P < 0.05 or P < 0.01). (2) The Cre level in CHF renal normal group,renal compensation group,renal decompensation group were 88.4±10.1, 92.2±8.5, 100.4±3.6. The Cre level in renal decompensation group were significantly higher than that in renal normal group and renal compensation group(p<0.05). The eGFR level in CHF renal normal group,renal compensation group,renal decompensation group were 94.61±7.44, 63.32±8.81, 49.59±2.54. Each two groups differences were statistically significant (p <0.05). The LVEF level in CHF renal normal group,renal compensation group,renal decompensation group were 0.45±0.14,0.41±0.12,0.39±0.13. Each two groups differences were statistically significant (p <0.05). (3) The rate of renal insufficiency were 40.0%,57.8%,62.5% and there were statistically significant differences in II,III,IV group(p <0.05). The rate of renal decompensation were 10.0%,22.2%,25.0% and there were statistically significant differences in II,III,IV group(p <0.05). The rate of renal compensation were 30.0%,35.6%,37.5% and there were no statistically significant differences in II, III, IV group(p >0.05). (4) NT-proBNP level in CHF renal normal group, renal compensation group,decompensation group were. 1483.93±565.97, 3096.83±128.27, 4035.89±1266.71. Each two groups differences were statistically significant (p <0.05). (5) The correlation analysis showed significantly positively correlations between NT-proBNP and Cre, LVEDD, LVEF, eGFR. Multiple linear regression analysis showed that eGFR were the most significant factor which affect NT-proBNP levels.Conclusion:(1)The renal damage prevalently exists in CHF patients.(2)Though Cre is normal , a part of CHF patients have renal insufficiency even some ones are renal decompensation. With the deterioration of heart function, the rate of renal insufficiency rise. (3) There was an independent correlation between the levels of NT-proBNP and LVEDD, eGFR,Cre,LVEDD. Along with the reduction of eGFR, NT-proBNP level rises.