Prevalence of kidney dysfunction and impact on one-year outcomes in patients with chronic heart failure in an African tertiary health center: a longitudinal study

Abstract

Background Data from Sub-Saharan Africa remains limited on the interaction of Kidney dysfunction and heart failure (HF). The study aimed to examine the prevalence and one-year outcomes of kidney dysfunction among patients with chronic HF managed at a tertiary hospital in Nigeria. Methods We conducted a prospective cohort study on adults 18 years or older with chronic HF who were enrolled and followed for 12 months. The stage of kidney dysfunction was classified using the estimated glomerular filtration rate. The primary outcomes were all-cause mortality and heart failure–related rehospitalization. Findings The data of 1267 HF patients (mean age 56.0 ± 16.6 years; 57% male) were analyzed. Moderate to severe kidney dysfunction was observed in 812 (64.1%) participants, and this category of patients was significantly older and had a significantly higher prevalence of hypertension and diabetes (p < 0.05). During the one-year follow-up, 235 deaths (18.9%) and 56 heart failure–related rehospitalizations (4.5%) were also observed. Mortality was higher among participants with moderate to severe kidney dysfunction compared to those with mild kidney dysfunction or normal kidney function (21.3% versus 13.6%, p=0.003). The independent predictors of all-cause mortality were the presence of kidney dysfunction (aHR 1.52, 95% CI 1.05–2.21, p=0.027); use of beta-blockers (aHR 0.61, 95% CI 0.44–0.83, p=0.002); and serum sodium (aHR 0.95, 95% CI 0.92–0.97, p < 0.001). Interpretation Kidney dysfunction was highly prevalent in the cohort and was independently predictive of one-year mortality. Routine kidney assessment and integrated cardio–renal management are essential to improve outcomes in this high-risk population. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.