PMID- 23155603
OWN - NLM
STAT- MEDLINE
DCOM- 20121211
LR  - 20150612
IS  - 0042-8450 (Print)
IS  - 0042-8450 (Linking)
VI  - 69
IP  - 10
DP  - 2012 Oct
TI  - Prevalence of renal dysfunction and its influence on functional capacity in 
      elderly patients with stable chronic heart failure.
PG  - 840-5
AB  - BACKGROUND/AIM: Chronic heart failure (CHF) is highly prevalent and constitutes 
      an important public health problem around the world. In spite of a large number 
      of pharmacological agents that successfully decrease mortality in CHF, the 
      effects on exercise tolerance and quality of life are modest. Renal dysfunction 
      is extremely common in patients with CHF and it is strongly related not only to 
      increased mortality and morbidity but to a significant decrease in exercise 
      tolerance, as well. The aim of our study was to investigate the prevalence and 
      influence of the renal dysfunction on functional capacity in the elderly CHF 
      patients. METHODS: We included 127 patients aged over 65 years in a stable phase 
      of CHF. The diagnosis of heart failure was based on the latest diagnostic 
      principles of the European Society of Cardiology. The estimated glomerular 
      filtration rate (eGRF) was determined by the abbreviated modification of diet in 
      renal disease (MDRD2) formula, and patients were categorized using the kidney 
      disease outcomes quality initiative (K/DOQI) classification system. Functional 
      capacity was determined by the 6 minute walking test (6MWT). RESULTS: Among 127 
      patients, 90 were men. The average age was 72.5 +/- 4.99 years and left 
      ventricular ejection fraction (LVEF) was 40.22 +/- 9.89%. The average duration of 
      CHF was 3.79 +/- 4.84 years. Ninty three (73.2%) patients were in New York Heart 
      Association (NYHA) class II and 34 (26.8%) in NYHA class III. Normal renal 
      function (eGFR > or = 90 mL/min) had 8.9% of participants, 57.8% had eGFR between 
      60-89 mL/min (stage 2 or mild reduction in GFR according to K/DOQI 
      classification), 32.2% had eGFR between 30-59 mL/min (stage 3 or moderate 
      reduction in GFR) and 1.1% had eGFR between 15-29 mL/min (stage 4 or severe 
      reduction in GFR). We found statistically significant correlation between eGFR 
      and 6 minute walking distance (6MWD) (r = 0.390, p < 0.001), LVEF (r = 0.268, p < 
      0.05), NYHA class (p = -0.269, p < 0.05) and age (r = 0.214, p < 0.05). In 
      multiple regression analysis only patients' age was a predictor of decreased 6MWD 
      < 300 m (OR = 0.8736, CI = 0.7804 - 0.9781, p < 0.05). CONCLUSION: Renal 
      dysfunction is highly prevalent in the elderly CHF patients. It is associated 
      with decreased functional capacity and therefore with poor prognosis. This study 
      corroborates the use of eGFR not only as a powerful predictor of mortality in 
      CHF, but also as an indicator of the functional capacity of cardiopulmonary 
      system. However, clinicians underestimate a serial measurement of eGFR while it 
      should be the part of a routine evaluation performed in every patient with CHF, 
      particularly in the elderly population.
FAU - Stanojevic, Dragana
AU  - Stanojevic D
AD  - Clinic for Cardiovascular Diseases, Clinical Center Nis, Nis, Serbia. 
      draganastanojevic1@gmail.com
FAU - Apostolovic, Svetlana
AU  - Apostolovic S
FAU - Jankovic-Tomasevic, Ruzica
AU  - Jankovic-Tomasevic R
FAU - Salinger-Martinovic, Sonja
AU  - Salinger-Martinovic S
FAU - Pavlovic, Milan
AU  - Pavlovic M
FAU - Zivkovic, Milan
AU  - Zivkovic M
FAU - Bozinovic, Nenad
AU  - Bozinovic N
FAU - Kutlesic-Kurtovic, Dusanka
AU  - Kutlesic-Kurtovic D
LA  - eng
PT  - Journal Article
PL  - Serbia
TA  - Vojnosanit Pregl
JT  - Vojnosanitetski pregled
JID - 21530700R
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Exercise Tolerance
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Heart Failure/complications/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Renal Insufficiency/*complications/physiopathology
EDAT- 2012/11/20 06:00
MHDA- 2012/12/12 06:00
CRDT- 2012/11/20 06:00
PHST- 2012/11/20 06:00 [entrez]
PHST- 2012/11/20 06:00 [pubmed]
PHST- 2012/12/12 06:00 [medline]
PST - ppublish
SO  - Vojnosanit Pregl. 2012 Oct;69(10):840-5.