Review Article

Heart-Kidney Interaction: Epidemiology of Cardiorenal Syndromes

Table 3

Summary of studies fulfilling criteria for Chronic Cardiorenal Syndrome (CRS Type 2).

StudyPopulation (n)Study type (data source)Cardiac diseaseCKDCardiac-specific outcomesOutcomes (%)

Heywood et al., 2007 [39]N = 118,465
Mean Age 61.7–76.3 yrs
Male 42%–57%
ADHERE registryADHFeGFR 60–89: 27.4%; eGFR 30–59: 43.5%; eGFR 15–29: 13.1%; eGFR < 15: 7%Use of cardioprotective meds (ACE-I and ARB) decreased with increasing degree of CKDOR for in-hospital mortality: eGFR ≥ 90: 1.0; eGFR 60–89: 2.3; eGFR 30–59: 3.9; eGFR 15–29: 7.6; eGFR < 15: 6.5
Elsayed et al., 2007 [40]N = 13826
Mean Age 58 yrs
Male 56%
Prospective (ARIC and CHS)Baseline CVD in 12.9%eGFR decrease of at least 15 ml/min/1.73 m2 to a final level < 60 ml/min/1.73  m2 was seen in 34% of patients with baseline CVDNAOR for development of kidney disease 1.54 (CVD versus non-CVD)
Ahmed et al., 2007 [41]N total = 7788
Mean Age 59.9–65.4 yrs
Male 76%–81%
Retrospective (DIG trial); Propensity-matched studyAmbulatory patients with CHFeGFR < 60 in 45%A graded association was found between CKD-related deaths and LVEFMatched HR: (CKD versus non-CKD) All-cause death 1.71
Campbell et al., 2009 [42]N total = 7788
Mean Age 59.9–65.4 yrs
Male 76%–81%
Retrospective (DIG trial); Propensity-matched studyAmbulatory patients with CHFeGFR < 60 in 45%Matched HR: (CKD versus non-CKD) CV hospitalization 1.17 HF hospitalization 1.08 CV death 1.24 HF death 1.42Matched HR: (CKD versus non-CKD) All-cause hospitalization 1.18
Dimopoulos et al., 2008 [43]N = 1102
Mean Age 36 yrs
Male 48.5%
Retrospective (single center)Adult congenital heart diseaseeGFR 60%–89 41% eGFR < 60 9% NAAll-cause death (HR) eGFR ≥ 90 1.0; eGFR < 60 3.25
Hillege et al., 2003 [44]N = 298
Mean Age 51–67 yrs
Male 70%
DM 16%–27%
HTN 6%–14%
Retrospective (CATS trial)1st anterior wall MIChange in GFRc Placebo: −5.5 ml/min/yr Captopril: −0.5 ml/min/yrNew CHF (RR) GFRc > 103: 1.0 GFRc 81–103: 1.23 GFRc < 81: 1.55All-Cause death: 1-yr 8%

ARIC: atherosclerosis risk in communities study; ADHF: acute decompensated heart failure: GFRc: GFR estimated by Cockroft Gault; CATS: captopril and thrombolysis study; CVD: cardiovascular disease; CVS: cardiovascular health study; DIG: digoxin investigator group.