Sunday, August 11, 2013

Cardiorenal anemia syndrome?

Apparently so:

Anemia and chronic kidney disease are common in patients with heart failure (HF) and are associated with adverse outcomes. We analyzed the effect of cardiorenal anemia (CRA) syndrome, defined as anemia (hemoglobin less than 130 g/L for men, less than120 g/L for women) and stage 3 or greater chronic kidney disease (estimated glomerular filtration rate less than 60 ml/min/1.73 m2), in outpatients with HF. Consecutive patients with HF were prospectively enrolled from 2000 to 2005 (n = 748)...
CRA syndrome was present in 224 patients (30%). These patients had greater all-cause mortality (51% vs 26%, p less than 0.001), older age (mean 77 ± 8 vs 67 ± 14 years, p less than 0.001), and greater rates of diabetes mellitus (35% vs 23%, p less than 0.001) and ischemic heart disease (50% vs 35%, p less than 0.001). The independent predictors of mortality were CRA syndrome (hazard ratio 2.0, 95% confidence interval 1.4 to 2.8, p less than 0.001), left ventricular systolic dysfunction per grade (hazard ratio 1.5, 95% confidence interval 1.3 to 1.8, p less than 0.001), the absence of a β blocker (hazard ratio 1.6, 95% confidence interval 1.1 to 2.2, p = 0.005), New York Heart Association class per class (hazard ratio 1.5, 95% confidence interval 1.2 to 1.9, p less than 0.01), and age per decade (hazard ratio 1.6, 95% confidence interval 1.4 to 2.0, p less than 0.001). In conclusion, CRA syndrome was common in patients with HF and was an independent predictor of all-cause mortality.

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