TITLE:
Distribution of Cardiorenal Syndrome Types and Associated Factors in a Cardiac Intensive Care Unit: A Pilot Study from a Private Facility in Congo-Brazzaville
AUTHORS:
Oelnis Consuegra Espinosa, Franck Yannis Kouikani, Armel Landry Batchi-Bouyou, Jorge Sarmiento Poulut, Carlos Enrique Garcia, Yohandy Reyes Cespedes, Laily Mujica Sanchez, Haunel Djanick Okagui, Jenisca Kimbembe, Garcia Nguimbi Mahoungou, Berthe Gemina Exaucée Ngoma, Jino Archange Mviramban, Christ Brunel Gonard, Gildas Christ Onze
KEYWORDS:
Cardiorenal Syndrome, Heart Failure, Chronic Kidney Disease, Intensive Care Unit, Congo-Brazzaville, Sub-Saharan Africa
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.16 No.6,
June
24,
2026
ABSTRACT: Background: Cardiorenal syndrome (CRS) represents a serious complication of heart failure, associated with high morbidity and mortality. In sub-Saharan Africa, data on CRS in cardiac intensive care units (ICU) remain limited, particularly in resource-constrained settings. Objective: To describe the distribution of CRS types and identify clinico-biological factors characterizing type 2 CRS (chronic cardiorenal) among patients diagnosed with CRS in a cardiac ICU in Brazzaville, Congo. Methods: Retrospective study conducted at Clinique Nouvelle Vie Médicité from September 9, 2024, to October 31, 2025. A census of all patients admitted to the cardiac ICU during the study period was conducted; Twenty-seven patients with a diagnosis of CRS were included. Demographic, clinical, biological, and echocardiographic characteristics were compared between type 1 CRS (acute) and type 2 (chronic). Firth penalized logistic regression was used for the multivariate model. The logistic regression aimed to characterize the phenotypic profile of type 2 CRS. Results: Of 27 patients diagnosed with CRS, 7 (25.9%) had type 1 CRS and 20 (74.1%) had type 2 CRS. Pre-existing chronic kidney disease (65.0% vs 14.3%, p = 0.033) and anemia (80.0% vs 28.6%, p = 0.024) were significantly more frequent in the type 2 CRS group. Differences in age, sex, clinical presentation, and echocardiographic parameters did not reach statistical significance in this small cohort. Renal function parameters (serum creatinine 4.7 ± 4.1 vs 1.6 ± 0.8 mg/L, p = 0.011; GFR 24.4 ± 18.4 vs 44.4 ± 17.9 mL/min/1.73 m2, p = 0.019) and hemoglobin levels (10.8 ± 2.2 vs 12.8 ± 1.4 g/dL, p = 0.028) differed significantly between groups. In multivariate analysis, known chronic kidney disease (adjusted OR = 8.38; 95% CI: 1.74 - 40.33; p = 0.006), anemia (adjusted OR = 5.25; 95% CI: 1.59 - 17.34; p = 0.037), and older age (adjusted OR = 0.64 per 10 years; 95% CI: 0.13 - 0.95; p = 0.022) independently characterized the type 2 CRS phenotype. Conclusion: Type 2 CRS predominates in our cardiac ICU. Pre-existing chronic kidney disease and anemia constitute major features characterizing this phenotype. These results underscore the importance of early screening for renal dysfunction and anemia management in heart failure patients in sub-Saharan Africa.