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All‐Cause Mortality in Elderly Adults Diagnosed with Cardiorenal Syndrome After an Internal Medicine Unit Admission
Author(s) -
Fabbian Fabio,
De Giorgi Alfredo,
Pala Marco,
Mallozzi Menegatti Alessandra,
Manfredini Roberto
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12525
Subject(s) - medicine , cardiorenal syndrome , kidney disease , renal function , heart failure , dialysis , diabetes mellitus , cohort , population , disease , creatinine , intensive care medicine , cardiology , pediatrics , endocrinology , environmental health
Background: Impaired kidney function is associated with all-cause and cardiovascular mortality even in oldest patients. The cardio-renal syndrome (CRS) is a heart and kidneys disorder in which the acute or chronic dysfunction of one can induce an acute or chronic dysfunction of the other, and is divided into 5 types. We aimed to evaluate the prognosis of a cohort of previously studied patients with different types of CRS after adequate follow-up.Subjects and methods: Population consisted of 438 Caucasians, selected among 2998 subjects consecutively discharged from our ward (June 2007-December 2009), and diagnosed with type 1 to 5 CRS according to Acute Dialysis Quality Initiative criteria. All-cause mortality was the final end-point, and mean follow-up was 2.4 ± 1.4 years.Results: Data for survival analysis were obtained in 374 patients (51.9% males). Mean age was 79.5±7.8 years, mean serum creatinine was 2.0±1.1 mg/dl, and eGFR was 31±12 ml/min/1.73 m2. One hundred forty-four deaths (38.7%) were recorded. Regression analysis showed that all-cause mortality was independently associated with age (HR=1.049, 95% CI 1.023-1.075, p<0.001), and eGFR (HR=0.972, 95% CI 0.957-0.988, p<0.001). Conclusions: In older persons, renal function cannot appropriately be measured by serum creatinine, and estimated GFR is strongly suggested. Studies on long-term mortality in older persons with CRS are limited. Even if different types of CRS appear to exhibit different survival curves, at least in our groups of elderly patients suffering from both heart and renal dysfunction, the main risk factors for all-cause mortality remain age and severity of renal failure