MO883: Cardiorenal Syndrome in Dialysis: Outcomes and Prognosis in Comparison With a Control Population. (3rd May 2022) - Suso, Andrea
Abstract: BACKGROUND AND AIMS: The interactions of both organs in Cardiorenal Syndrome (CRS) exacerbate the damage and determine a worse prognosis in these patients [1 ]. The aim of our study is to compare the development and prognosis of CRS patients compared with control patients. METHOD : In a retrospective fashion, we assigned 60 patients with CRS who underwent dialysis, and we compared them with a control population of 60 patients without CRS in dialysis. We analyzed baseline characteristics of the patients and the dialysis parameters. Survival rates at 1 and 5 years were determined. RESULTS: The baseline characteristics were similar between groups. The mean age was 72 ± 9 years in CRS and 68 ± 12 years in the control group. Men were more prevalent in both groups CRS (55%) and control (53%). Charlson's Score was 8 ± 2 points in the CRS group and 7 ± 3 points in the control group. Diabetic nephropathy was the most frequent etiology of end-stage renal disease in CRS patients (37%), followed by nephroangiosclerosis (20%). In the control group, the most common etiologies were nephroangiosclerosis (32%), diabetic (22%) and interstitial nephropathy (11%). CRS patients had more diabetes mellitus (55% versus 35%; P < 0.05), dyslipidemia (63% versus 38%; P < 0.05), ischemic cardiopathy (50% versus 31%; P < 0.05), atrial fibrillation (66% versus 21%; P < 0.05) and valvular heart disease (27% versus 6%; P < 0.05). There were no differences in hypertension (80% versus 76%; P = 0.58), ictus (31% versus 23%; P = 0.30) and peripheral arterial disease (40% versus 33%; P = 0.44) between groups. CRS patients had more hospitalizations due to heart failure before starting dialysis than the control group (52% versus 1.7%; P < 0.05) Haemodialysis was the most common technique in both groups CRS (98%) and control (95%). The use of permanent tunneled catheters as definite vascular access was more common in CRS patients (60% versus 26%; P < 0.05). There were no differences in the duration of haemodialysis sessions (252 ± 18 versus 257 ± 23 min), neither in interdialytic weight gain (2.3 ± 0.7 versus 2.4 ± 0.9 Kg). CRS patients had worse ultrafiltration tolerance with a hypotension rate of 48% in CRS versus 10% in the control group ( P < 0.05). The median time in dialysis was inferior in the CRS group [24 (8–42) versus 61 (26–106) months; P < 0.05] compared with controls and the survival rates at 1 and 5 years were worse in the CRS group (71% versus 93%; P < 0.05) and (15% versus 50%; P < 0.05), respectively. The main cause of death was the cardiovascular events in both groups (35% versus 20%; P = 0.06). However, tumor as a cause of death was superior in the control group (18% versus 0%; P < 0.05). CONCLUSION: CRS patients have more cardiovascular risk factors and cardiovascular disease as expected, as well as more hospitalizations caused by heart failure before starting dialysis. They have more frequent use of a permanent tunneled catheter. It could be explained because of worse tolerance to the use of arteriovenous fistula in these patients. - The survival rates at 1 and 5 years are significantly inferior in the CRS group, which highlights the poor prognosis of these patients [2, 3 ]. - The tumor as a cause of death was superior in the control group due to greater time in dialysis of these patients compared with CRS patients