慢性心力衰竭患者中的贫血、肾功能不全及其相互作用

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:jiekoala
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Anemia and renal dysfunction(RD) are frequent complications seen in chronic heart failure(HF). However, the prevalence and interaction of these co-morbidities in a representative population of outpatients with chronic HF is poorly described. In this study, it was sought to determine the association between RD and anemia in patients with HF enrolled in a community-based HF program. Nine hundred fifty-five patients with HF due to left ventricular systolic dysfunction were investigated for the prevalence of anemia and its cause and followed for a median of 531 days. Anemia was defined as hemoglobin< 12.0 g/dl in women and< 13.0 g/dl in men. RD was defined as a calculated glomerular filtration rate of< 60 ml/min. The prevalence of anemia was 32%. Fifty-three percent of patients with and 27%of those without anemia had ≥1 test suggesting hematinic deficiency. The prevalence of RD was 54%. Forty-one percent of patients with and 22%of patients without RD had anemia, with similar proportions associated with iron deficiency in the presence or absence of RD. Anemia and RD independently predicted a worse outcome, and this effect was additive. In conclusion, in outpatients with chronic HF, anemia and RD are common and co-exist but confer independent prognostic information. A deficiency of conventional hematinic factors may cause about 1/3 of anemia in this clinical setting. Anemia and renal dysfunction (RD) are frequent complications seen in chronic heart failure (HF). However, the prevalence and interaction of these co-morbidities in a representative population of outpatients with chronic HF is poorly described. In this study, it was sought to determine the association between RD and anemia in patients with HF en anemia in patients with HF enrolled in a community-based HF program. Nine hundred fifty-five patients with HF due to left ventricular systolic dysfunction were investigated for the prevalence of anemia and its cause and followed for a median of 531 days. Anemia was defined as hemoglobin <12.0 g / dl in women and <13.0 g / dl in men. RD was defined as a calculated glomerular filtration rate of <60 ml / min. The prevalence of anemia was 32%. Fifty -three percent of patients with and 27% of those without anemia had ≥1 test suggesting hematinic deficiency. The prevalence of RD was 54%. Forty-one percent of patients with and 22% of patients without RD had anemia, with similar proportions associated with iron deficiency in the presence or absence of RD. Anemia and RD independently predicted a worse outcome, and this effect was additive. In conclusion, in outpatients with chronic HF, anemia and RD are common and co-exist but confer independent prognostic information A deficiency of conventional hematinic factors may cause about 1/3 of anemia in this 临床 setting.
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