Acute Childhood Cardiorenal Syndrome and Impact of Cardiovascular Morbidity on Survival

Abstract

Cardiorenal syndrome (CRS) clinical types, prevalence, aetiology, and acute cardiovascular morbidity impact on the outcome of acute kidney function perturbation were determined. Forty-seven of 101 (46.53%) patients with perturbed kidney function had CRS. Types 3 and 5 CRS were found in 10 and 37 patients, respectively. Type 3 CRS was due to acute glomerulonephritis (AGN; 𝑛=7), captopril (𝑛=1), frusemide (𝑛=1), and hypovolaemia (𝑛=1). Malaria-associated haemoglobinuria (𝑛=20), septicaemia (𝑛=11), lupus nephritis (𝑛=3), tumour lysis syndrome (𝑛=2), and acute lymphoblastic leukaemia (𝑛=1) caused Type 5 CRS. The cumulative mortality in hypertensive CRS was similar to nonhypertensive CRS (51.4% versus 40.9%; 𝑃=.119). Mortality in CRS and non-CRS was similar (45.7% versus 24.5%; 𝑃=.053). Type 5 survived better than type 3 CRS (66.7% versus 12.5%; 𝑃=.001). Risk factors for mortality were Type 3 CRS (𝑃=.001), AGN-associated CRS (𝑃=.023), dialysis requiring CRS (𝑃=.008), and heart failure due to causes other than anaemia (𝑃=.003). All-cause-mortality was 34.2%. Preventive measures aimed at the preventable CRS aetiologies might be critical to reducing its prevalence.