ALTERATION IN RENAL FUNCTION FOLLOWING LOOP DIURETIC IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE
Objective: To monitor the impact of loop diuretic therapy in patients with Acute Decompensated Heart Failure (ADHF) and to assess other predictors of renal dysfunction in patients with ADHF.
Methods: An observational study over a period of 6 months from January 2018 to June 2018 in the department of Cardiology, in a tertiary care teaching hospital, Coimbatore, Tamil Nadu. Patients on diuretic therapy (loop diuretic) were enrolled. Patients with prior chronic kidney disease were excluded. The patients were evaluated based on the change in serum creatinine and other contributing factors were assessed by Acute Kidney Injury Network (AKIN) and Worsening of Renal Function (WRF) criteria.
Results: A total of 135 patients were enrolled, out of which 73% were males and 27% were females. The mean age of the subjects was 61.55 ± 13 years. The baseline mean serum creatinine was 1.62±0.92mg/dl. On evaluation, 41% were renally affected and 59% remain unaffected. Factors like Hypertension (p = 0.047) and ACE-I (p = 0.023) were found to be significant predictors of renal injury.
Conclusion: Variation in renal function in ADHF patients was multifactorial. The direct influence of loop diuretics on renal function was present, but was not well established. Hypertension and Angiotensin Converting Enzyme Inhibitors (ACE-I) showed influence in the development of renal injury as contributing factors. There exists both positive and negative consequence of loop diuretics on renal function.
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