Prognostic value of renal function estimating formulas in type 2 cardiorenal syndrome

Abstract

Introduction. Renal function worsening is often observed in chronic heart failure (CHF). Glomerular filtration rate (GFR) is widely accepted as a marker for renal function evaluation, and usually, is estimated with the use of creatinine-based formulas.Purpose.To compare the prognostic value of estimating glomerular filtration rate formulas in type 2 cardiorenal syndrome.Material and methods.A total of 170 consecutive hospitalized CHF patients with intermediate or reduced ejection fraction and renal changes (51.8 % men, age 68.33 ± 1.06 years) were studied. Renal function and GFR) was assessed using the most popular formulas for GFR estimation: the Cockcroft-Gault (CG), the four-variable Simplified Modification of Diet in Renal Disease (sMDRD), CKD-EpidemiologyDiet in Renal Disease (sMDRD), CKD-Epidemiology Collaboration (CKD-EPI) based on serum cystatin-C, creatinine and their combination, and the simple cystatin-C formula.Results.During 6 months follow-up, 29 (16.2%) deaths were recorded. Renal biomarkers and estimated GFR showed different prognostic value. AUC was 0.58 (95%CI:0.47-0.69, P = 0.05) for creatinine, 0.67 (95% CI: 0.56-0.79, P< 0.05) for cystatin-C. Conclusions.GFR is an independent predictor for type 2 cardiorenal syndrome short term mortality. Cystatin-C based formulas for offer improved prognostication in this population, while CG formula, serum cystatin-C and serum creatinine fail to predict short term mortality.