Effect Of Residual Renal Function On Heart Failure In Maintenance Hemodialysis Patients

Objective:To investigate the effect of residual renal function on heart failure in Maintenance hemodialysis（MHD）patients,and to understand whether residual renal function can predict the occurrence of heart failure in MHD patients and the influencing factors of heart failure in HD patients.Methods:A total of 114 patients who underwent regular dialysis for more than 3 months at the blood purification center（II）of the Hefei Second People’s Hospital from March 2021 to September 2021 were consecutively enrolled in the study.The baseline data of all hospitalized patients were collected in detail.Demographic data（age,gender）,dialysis factors（vascular access,primary disease,comorbidities,dialysis shifts）,laboratory indicators(Glu,Scr,BUN,UA,CRP,Ca²⁺,CHOL,TG,HDL,LDL,ALB,β2-microglobulin),cardiac ultrasound（LVEF,FS）and Residual Renal Function（RRF）.According to the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic Heart Failure,patients who met the inclusion and exclusion criteria were divided into heart failure group（HF）and Non-heart failure group（NHF）.The differences in baseline and clinical data between the HF group and the NHF group were compared.Variables with P<0.10 were included in the binary logistic regression model to calculate the odds ratio（OR）and 95%confidence interval（CI）,and P<0.05 was considered statistically significant.Results:（1）A total of 114 MHD patients were enrolled in this study,including 33 patients（22.9%）in the HF group and 81 patients（56.3%）in the NHF group.There were 8 patients with RRF and 25 patients without RRF in the HF group.There were no significant differences in age,gender,vascular access,dialysis shifts,blood lipids,ALB,β2-MG,and electrolytes between the two groups（P<0.05）;There were significant differences between patients with RRF and those without RRF（24.2%vs 53.1%,75.80%vs 46.90%,2=-2.886,P=0.005）.The EF in NHF group was 63.0（59.8,67.0）,which was significantly higher than that in HF group 54.7（46.5,61.5）（P<0.05）.（2）With heart failure as the dependent variable,the factors with statistical differences（P<0.05）between the HF group and the NHF group,namely Glu,Scr,UA,iPTH,PA,RRF（with residual renal function assignment=1,without residual renal function assignment=0）,LVEF,FS and other factors,were analyzed by univariate regression analysis one by one.Multivariate Logistic regression analysis showed that RRF,LVEF,UA and PA were protective factors for heart failure,and increased iPTH and Scr were independent risk factors for heart failure.Conclusion:In MHD patients,the preservation of RRF may reduce the occurrence of HF,and LVEF,UA and PA are protective factors for HF in MHD patients.High levels of RRF,LVEF,UA and PA can reduce the occurrence of HF and delay the progression of the disease.Increased iPTH and Scr are independent risk factors for heart failure.