Cardio-Renal Syndrome: Frequency and Associated Factors in the Abidjan Heart Institute’s Medical Department
- 1 Nephrology Department of the Teaching Hospital of Treichville, Abidjan, Ivory Coast
- 2 Heart Institute of Abidjan, Abidjan, Ivory Coast
- 3 Nephrology Department of the Teaching Hospital of Treichville, Abidjan, Ivory Coast
- 4 Nephrology Department of the Teaching Hospital of Treichville, Abidjan, Ivory Coast
- 5 Nephrology Department of the Teaching Hospital of Treichville, Abidjan, Ivory Coast
- 6 Heart Institute of Abidjan, Abidjan, Ivory Coast
- 7 Nephrology Department of the Teaching Hospital of Treichville, Abidjan, Ivory Coast
Abstract
Introduction: Cardio-renal syndrome (CRS) is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one organ can lead to acute or chronic dysfunction of the other. In Africa, particularly in C?te d’Ivoire, the incidence of cardio-renal syndrome is not precisely known. The aim of this study was to assess the frequency of CRS and to contribute to a better understanding of the condition in the medical department of the Abidjan Heart Institute. Materials and Methods: We conducted a prospective analytical study including all patients with heart failure hospitalised in the medicine department of the Abidjan Heart Institute from March to October 2020. Data were analysed using SPSS software version 22. Results: We included 111 patients in the study. The incidence of CRS was 64%, with a predominance of males (sex ratio 1.8). The mean age was 53 ± 15 years. Patients’ medical history was dominated by hypertension (56.8%), diabetes (15%), dyslipidaemia (18%), obesity (17.1%) and smoking (14.4%). The main causes of heart failure were dilated cardiomyopathy (22.8%) and ischaemic heart disease (21.4%). Symptomatology was mainly congestive heart failure (42.8%). Mean evaluated clearance (MDRD) was 39.9 ± 17.1 ml/min/m 2 . Doppler echocardiography showed a decrease in left ventricular ejection fraction in 74.3% of patients. Factors statistically associated with the occurrence of cardio-renal syndrome were: age > 60 years (p = 0.04), diabetes (p = 0.03), arterial hypertension (p = 0.001) and Hb < 10 g/dl (p = 0.02). In terms of evolution, total recovery of renal function was observed in 41.4% of cases and 58.6% progressed to chronic kidney disease (CKD). One patient died. Conclusion: The cardio-renal syndrome is a reality and marks an important point in the evolution of cardiac and renal diseases. It is highly frequent in the medical department of the Abidjan Heart Institute, as well as a high rate of CKD.
- Mayosi, B.M. (2007) Contemporary Trends in the Epidemiology and Management of Cardiomyopathy and Pericarditis in Sub-Saharan Africa. Heart (British Cardiac Society), 93, 1176-1183. https://doi.org/10.1136/hrt.2007.127746
- Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J.J.V., Ponikowski, P., Poole-Wilson, P.A., et al. (2008) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). European Journal of Heart Failure, 10, 933-989. https://doi.org/10.1016/j.ejheart.2008.08.005
- Zannad, F., Briancon, S., Juilliere, Y., Mertes, P.M., Villemot, J.P., Alla, F., et al. (1999) Incidence, Clinical and Etiologic Features, and Outcomes of Advanced Chronic Heart Failure: The EPICAL Study. Epidémiologie de l’Insuffisance Cardiaque Avancée en Lorraine. Journal of the American College of Cardiolog, 33, 734-742. https://doi.org/10.1016/S0735-1097(98)00634-2
- Affangla, D.A., Ba, F., Ba, D.M., Ndiaye, M., Mboup, W.N., Wabo, A.S., et al. (2019) Epidémiologie et étiologie de l’insuffisance cardiaque chez l’adulte au centre DIABCARMET de l’hôpital Saint Jean de Dieu de Thiès (Sénégal). Revue Africaine de Médecine Interne, 6, 29-37.
- Pio, M., Afassinou, Y., Pessinaba, S., Baragou, S., N’djao, J., Atta, B., et al. (2014) Epidémiologie et étiologies des insuffisances cardiaques à Lomé. The Pan African Medical Journal, 18, 183.
- Goursaud, S. and Du Cheyron, D. (2014) Le syndrome cardiorénal: Diagnostic, physiopathologie et prise en charge. Réanimation, 23, 585-594. https://doi.org/10.1007/s13546-014-0897-6
- Ronco, C., Haapio, M., House, A.A., Anavekar, N. and Bellomo, R. (2008) Cardiorenal Syndrome. Journal of the American College of Cardiology, 52, 1527-1539. https://doi.org/10.1016/j.jacc.2008.07.051
- Yao, K.H., N’guetta, R., Sanogo, S., Hue Lou, A., Sery, S.L. and Diallo, A.D. (2013) Le syndrome cardio-rénal dans un service de médecine interne à Abidjan, Cote d’ivoire: à propos de 70 cas. Médecine d’Afrique Noire électronique, 60, 38-44.
- Attias, D., Pezel, T. and Lellouche, N. (2021) KB/iKB Cardiologie vasculaire R2C nouvelle édition revue et adaptée. Collège National des Cardiologues Français. 9è édition, Vernazobres Grego.