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Revista Colombiana de Cardiología

Print version ISSN 0120-5633

Abstract

RODRIGUEZ, Diego  and  GOMEZ, Efraín. Prevalence of heart failure in patients attending to a heart failure clinic. Rev. Colom. Cardiol. [online]. 2011, vol.18, n.3, pp.144-153. ISSN 0120-5633.

Background: patients with heart failure have an increased morbidity to the extend that they present impaired renal function, taking as a predictor of adverse events the elevation of creatinine clearance. Methods: a descriptive analysis of patients attending the heart failure clinic of the Shaio Clinic from January 1997 until October 2009 was realized, in order to know their renal function through creatinine clearance using the Cockcroft formula. Risk factors taken into account were the presence of hypertension, diabetes mellitus, smoking and dyslipidemia, and some drugs that can affect renal function, such as spironolactone, digitalis, angiotensin-converting enzyme and antagonists of angiotensin II receptors were also assessed, as well as the etiology correlated with creatinine clearance. Results: 1,123 patients were registered in the data base, of whom 557 (49.6%) meet the inclusion criteria, and of these 461 (82.8%) present impaired renal function. 301 (65%) are males and 160 (35%) female. Based on the creatinine clearance, the finding were: between 60-89 mL/min 172 patients (37.6%); between 30-59 mL/min 240 patients(51.8%); between 15-29 mL/min 42 patients (9.1%); less than 15 mL/min 7 patients(1.5%). Among the risk factors we found for arterial hypertension in 59.2% of patients, dyslipidemia in 49.6%, smoking in 23.9% and diabetes in 18.5%. The most commonly used drug was spironolactone in 70.2% of patients, followed by inhibitors of angiotensin converting enzyme in 52.1%, diuretics in 52%, digitalis in 45.4% and finally angiotensin receptor II antagonists in 36.1%. The most common etiology was ischemic heart disease followed by hypertension. Conclusions: the prevalence of renal failure determined by creatinine clearance is high for both men and women evaluated in the clinic for heart failure, which leads to rethinking management schemes depending on renal function, given that some of the drugs used are nephrotoxic or increase potassium levels. Therefore, assessment of renal function using creatinine clearance using the Cockcroft formula may be more convenient than being based only in creatinine; therefore, its performance is recommended in all patients who are being followed in the heart failure clinics as well as when considering changes in the pattern of medical management.

Keywords : kidney; heart failure; hypertension.

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