Prevalence of renal dysfunction and its influence on functional capacity in elderly patients with stable chronic heart failure

Abstract

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.

Estimated Glomerular Filtration Rate and 6-Minute Walk Distance in African Americans with Mild to Moderate Heart Failure

“…Similarly, Alahdab and colleagues [16] found that AA patients hospitalized with HF who walked a shorter distance were more likely to have an eGFR <60 mL/min/1.73 m 2 by the MDRD equation and to be female and older (59.4 vs. 50.3 years). European investigators also reported significant correlations between eGFR and 6MWD in patients >65 years of age (mean age = 72.5 ± 5 years); however, contrary to our study, they did not find eGFR to be a predictor of 6MWD [10]. Importantly, our study participants were AA and younger (mean age = 64.8 ± 9 years).…”

“…To our knowledge, the relationship between kidney function and functional capacity has not been determined in AA patients with chronic HF. Data support a relationship, in that Stanojevic et al [10] investigated estimated glomerular filtration rate (eGFR) in relation to functional capacity in 127 HF patients (70% European male, >65 years of age) and found that eGFR correlated with 6-minute walk distance (6MWD; r = 0.390, p < 0.01). However, in multiple regression, only age significantly predicted 6MWD <300 m [10].…”

“…Data support a relationship, in that Stanojevic et al [10] investigated estimated glomerular filtration rate (eGFR) in relation to functional capacity in 127 HF patients (70% European male, >65 years of age) and found that eGFR correlated with 6-minute walk distance (6MWD; r = 0.390, p < 0.01). However, in multiple regression, only age significantly predicted 6MWD <300 m [10]. Because of the well-known cardiorenal interaction and high prevalence of CKD among AA patients with HF, it is important to determine if there is an association between eGFR and functional capacity using parameters that are routinely measured and monitored in the clinical setting.…”

Heart Failure Care in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

“…Four studies involved both inpatient and outpatient data [22],[24],[26],[36], six studies referred solely to patients seen at outpatient clinics [27],[39],[61],[66],[67],[70], three studies described heart failure in primary care settings [62]–[64], and the remainder reported solely on inpatient populations. One study was a population-based assessment of the prevalence of heart failure in Turkey [63].…”

“…Information on the use of additional investigative tools, including echocardiography, chest radiography, and electrocardiography, was provided in 28 studies [19]–[21],[24]–[26],[28],[31],[35],[39],[41]–[43],[46],[48]–[50],[51],[54],[56],[57],[59],[61],[63],[64],[66],[70],[73]. Of these, 14 studies performed echocardiography on all patients [19],[24]–[26],[28],[35],[46],[48],[53],[54],[59],[61],[63],[66]. The mean left ventricular ejection fraction (LVEF) was documented in 18 studies, reporting data from Algeria [70], Egypt [70], Tunisia [70], Cameroon [24], Ethiopia [35], Sudan [35], Mozambique [35], Kenya [35], Uganda [35], Senegal [35], South Africa [25], Nigeria [26],[28], Brazil [19],[39],[42],[46],[66], Chile [41],[70], Colombia [70], Mexico [70], Romania …”