Abstract: PUB049
Effect on Hospitalizations of Integrating a Cardiorenal Clinic for Patients with Heart Failure and Advanced Kidney Disease
Session Information
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Nieves Hernández, Luz Atenas, Tecnologico de Monterrey Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico
- Arvizu Hernández, Mauricio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
- Barron, Clemente, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
Background
Patients with chronic kidney disease (CKD) and heart failure (HF) have an increased cardiovascular risk, guideline-directed medical therapy for heart failure (HF) in patients with advanced CKD has been explored in limited observational studies.
Methods
89 patients were included in cardiorenal clinic; 52% were male, with a mean age of 42.3 years (±16.0). Most patients (85%) were on renal replacement therapy, and the rest were predialysis with a mean eGFR of 19.7 mL/min/1.73 m. CKD etiologies included unknown (29%), others (29%), lupus (19.1%), and DM (17.9%). HF categories were 46 (51.6%) HfpEF; 22 (24.7%) HfrEF and 18 (20.2%) HFmrEF. The average follow up duration was 718 (+/-512 ) days. Treatment was optimized for all patients in accordance with current guidelines, with close monitoring of tolerability and the occurrence of adverse effects.
Results
Hospitalizations were analyzed for the 6 months before and after admission to the cardiorenal clinic; the rates were adjusted for monthly hospitalizations and hospitalizations per patient per average follow-up time. A significant decrease was observed in all parameters.
Conclusion
Close management in accordance with treatment guidelines for patients with heart failure and chronic kidney disease—including SGLT2 inhibitors, mineralocorticoid receptor antagonists, ACE inhibitors/ARBs, beta-blockers, etc.—as well as close follow-up has a positive impact on patient prognosis, reducing hospitalizations and opening the door to kidney transplantation