[Probability of acute heart failure in chronic kidney disease].

BACKGROUND

In Mexico 130,000 people live with chronic kidney disease (CKD). Heart conditions are the most frequent clinical problems; 45% of the deaths of patients in replacement therapy have a cardiac origin.

OBJECTIVE

To identify the probability of presenting acute heart failure (AHF) in patients with CKD in the Adult Emergency Department (AED) of a second-level hospital.

MATERIAL AND

METHODS

Case-control study with 111 cases and 103 controls. Cases were defined as patients with CKD admitted to AED for AHF compared with controls: patients with CKD who were admitted for a different diagnosis. Binary logistic regression was performed and odds ratio (OR) and 95% confidence intervals (95% CI) were determined. A value of p ˂ 0.05 was considered significant.

RESULTS

Arterial hypertension (OR 7.12, 95% CI 2.3-22.06, p = 0.01), the use of 3 or more antihypertensive drugs (OR 2.903, 95% CI 1.19-7.11, p = 0.02), the use of inhibitors of angiotensin converting enzyme (ACE inhibitors) (OR 4.25, 95% CI 1.78-10.09, p = 0.01), angiotensin II receptor blockers (ARBs) (OR 2.41, 95% CI 1.19-4.89, p = 0.014), diuretics (OR 42.87, 95% CI 9.02-203.63, p = 0.00), peritoneal dialysis (OR 2.48, 95% CI 1.25-4.81, p = 0.009) and hemodialysis (OR 0.40, 95% CI 0.20-0.79, p = 0.009) had statistical significance.

CONCLUSIONS

CKD patients with arterial hypertension, use of ACE inhibitors, ARBs, diuretics and peritoneal dialysis were more likely to present AHF, while patients who were on hemodialysis were less likely to presenting it.