Incidence And Risk Factors Of Worsening Renal Function Among Patients Hospitalized With Chronic Heart Failure

Objective:1. Observe incidence and clinical characteristics of chronic heart failure with renal dysfunction.2. Observe incidence and clinical characteristics of chronic heart failure with worsening of renal function.3. To explore the cause of chronic heart failure in hospitalized patients with worsening of renal function.Methods:The study population included the CHF patients with New York Heart Association (NYHA) class Ⅲ and Ⅳ, who were admitted to the Department of Cardiology in Shanghai No.6People’s Hospital Jinshan Branch between2012.Ito2012.6.Collection the following items: record number, name, sex, age, discharge diagnosis, admission blood pressure, LVEF, Left ventricular diameter, BUN, Scr, the concentration of hemoglobin, the maximum difference of Scr before discharge, the main application of drugs during hospitalization. Estimation of GFR was MDRD equation of the simplified. The objective was to compare the clinical characteristics of renal dysfunction group and non renal dysfunction group. Through the calculation of changes of Scr of hospitalized patients with CHF, compare clinic characteristics and influence factors of the two group.Result:1. There were38.21%patients with renal insufficiency. Renal insufficiency was associated with advanced age, history of hypertension, history of diabetes, anemia, high uric acid, urea nitrogen, brain natriuretic peptide, hyponatremia with statistical relevance.2. There were22.76%patients with worsening renal function. Worsening renal function was associated with renal insufficiency, anemia, hyponatremia, blood acid-base imbalance, high brain natriuretic peptide, gastrointestinal nutrition disorders, blood pressure, intravenous diuretics with statistical correlation.3. Worsening renal function was related throuth the regression model of factors with anemia, hyponatremia, kidney function.Conclusions:1. Renal insufficiency was common in the hospitalized patients with moderate to severe CHF(38.21%), especially in the old patients or the patients with history of hypertension, history of diabetes, anemia, high uric acid, urea nitrogen, brain natriuretic peptide, hyponatremia.2. Worsening renal function was occurred in22.76%of the hospitalized patients with moderate to severe CHF, which was associated with serious base renal function. Worsening renal function was also associated with anemia, hyponatremia, blood acid-base imbalance, high brain natriuretic peptide, gastrointestinal nutrition disorders, blood pressure, intravenous diuretics. 3. CHF patients with renal insufficiency, anemia, hyponatremia, was easily leaded to worsening renal function.