FREQUENCY OF RENAL DYSFUNCTION IN PATIENTS ADMITTED WITH ACUTE DECOMPENSATED HEART FAILURE AT A TERTIARY CARE HOSPITAL

Abstract

Background: Acute decompensated heart failure (ADHF) is a critical clinical condition frequently complicated by renal dysfunction, which significantly worsens patient outcomes. The cardiorenal interaction poses diagnostic and therapeutic challenges, particularly in low-resource settings. Globally, renal dysfunction is recognized as an independent predictor of mortality in heart failure patients. In Pakistan, where comorbidities like diabetes and hypertension are highly prevalent, local data on renal impairment in ADHF remains limited, necessitating focused research to guide early risk identification and integrated management strategies.

Objective: To determine the frequency of renal dysfunction in patients admitted with acute decompensated heart failure at a tertiary care hospital.

Methods: A descriptive cross-sectional study was conducted over six months in the Adult Cardiology Department of the National Institute of Cardiovascular Diseases, Karachi. A total of 140 patients aged 18–75 years, with a primary diagnosis of ADHF, were enrolled using consecutive non-probability sampling. Serum creatinine, blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR) were measured using standard protocols. Renal dysfunction was defined as eGFR < 60 mL/min/1.73 m² using the CKD-EPI equation. Data were analyzed using SPSS version 26, applying descriptive statistics, stratification, and inferential tests with p<0.05 considered significant.

Results: The mean age was 61.0 ± 9.0 years and mean BMI was 27.2 ± 3.5 kg/m². Males constituted 62.9% and 72.1% of patients were from urban areas. Hypertension was present in 75.7%, diabetes mellitus in 58.6%, and ischemic heart disease in 50.0% of cases. NYHA class III and IV were observed in 50.7% and 25.0%, respectively. The mean serum creatinine was 1.9 ± 0.6 mg/dL, BUN 26.4 ± 7.3 mg/dL, and eGFR 48.7 ± 19.6 mL/min/1.73 m². Renal dysfunction was noted in 77.9% of patients.

Conclusion: Renal dysfunction was highly prevalent in patients admitted with ADHF and strongly associated with advanced functional class and comorbid conditions. These findings support routine renal assessment to guide comprehensive management in heart failure care.