TITLE:
Clinical Profile and Outcomes of Acute and Chronic Type 5 Cardiorenal Syndrome
AUTHORS:
Mariam El Galiou, Samia El Hilali, Naima Ouzeddoun, Tarik Bouattar, Nawal Doghmi, Laila Lahlou, Loubna Benamar
KEYWORDS:
Type 5 Cardiorenal Syndrome, Sepsis, Systemic Disease, Acute Kidney Injury, Diabetes
JOURNAL NAME:
Open Access Library Journal,
Vol.11 No.8,
August
29,
2024
ABSTRACT: Introduction: Type 5 cardio-renal syndrome (CRS) is characterized by the combination of renal failure and heart failure secondary to an acute or chronic systemic disease. The most common situation of acute systemic involvement responsible for type 5 CRS is sepsis. The objective of our study is to determine the epidemiological, clinical, and therapeutic profile of patients with acute and chronic type 5 CRS and to identify the prognostic factors associated with type 5 CRS. Materials and Methods: This is a descriptive and analytical study conducted between the nephrology and cardiology departments of the Ibn Sina University Hospital in Rabat. Over a period of one year, we identified 120 patients with CRS. We studied and analyzed patients with type 5 CRS (46%). Two groups of patients with type 5 CRS were defined and compared to analyze the epidemiological, clinical, and therapeutic profile of each group. Group 1 included patients with acute type 5 CRS, and Group 2 included patients with chronic type 5 CRS. We also investigated the risk factors for mortality associated with type 5 CRS. Results: Among the 120 patients with CRS, those with type 5 CRS represent 46%. Chronic type 5 CRS is significantly associated with diabetes, hypertension, and chronic kidney disease (CKD). AL amyloidosis was found in two of our patients with chronic type 5 CRS. Acute type 5 CRS was found in 20% of our patients, with severe sepsis being the predominant etiology in 72% of cases, followed by systemic lupus erythematosus in 28% of cases. The use of renal replacement therapy (RRT) was indicated in 45.5% of patients in Group 1, while mortality occurred in 36.4% of these patients. In univariate and multivariate analysis, we found that the risk factors for mortality associated with type 5 CRS are prolonged stays in the cardiac intensive care unit (CICU), the use of RRT, and acute type 5 CRS (p = 0.015, p = 0.031, p = 0.04). Conclusion: In our study, the prevalence of type 5 CRS is 46%. The etiology of acute type 5 CRS is dominated by sepsis, whereas chronic type 5 CRS is dominated by diabetes and hypertension. The risk factors for mortality associated with type 5 CRS are primarily; acute type 5 CRS, prolonged stays in CICU, and the use of RRT.