Clinical and demographic characteristics, therapeutic strategies, and outcomes in cardiology patients by renal function

Objective: to conduct a comparative analysis of clinical, demographic, therapeutic, and prognostic aspects in hospitalized cardiology patients depending on the presence of chronic kidney disease (CKD).

Material and methods: The study included 780 cardiology patients divided into groups with CKD (n = 207) and without CKD (n = 573). A retrospective analysis of medical records was performed to assess demographic, clinical, therapeutic, and laboratory parameters, as well as hospitalization outcomes. Statistical analysis was performed using Student’s t-test, the Mann-Whitney U test, and the χ² test in IBM SPSS Statistics 26.0, with p < 0.05 considered statistically significant.

Results: Patients with CKD were older (71.1 ± 10.9 vs 61.8 ± 15.1 years; p < 0.001) and had a significantly higher prevalence of chronic heart failure (CHF) (77.3% vs 23.9%), diabetes mellitus (DM) (51.7% vs 27.4%), and atrial fibrillation

(AF) (44.0% vs 24.4%; p < 0.001). Decompensated CHF was the leading cause of hospitalization in these patients (58.5% vs 24.1%; p < 0.001). During hospitalization, patients with CKD were less likely to receive angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin II receptor blockers (ARBs) (42.5% vs 88.8%; p < 0.001), but were more likely to receive diuretics, anticoagulants, mineralocorticoid receptor antagonists (MRAs), angiotensin receptor-neprilysin inhibitors (ARNIs), and sodium-glucose cotransporter 2 (SGLT2) inhibitors (p < 0.01). CKD was associated with longer hospitalization (12.5 ± 5.8 vs 8.2 ± 4.1 days; p < 0.001), higher mortality (8.7% vs 3.8%; p = 0.008), and a higher rate of transfer to the intensive care unit (ICU) (21.7% vs 13.6%; p = 0.006).

Conclusions: CKD defines a distinct clinical phenotype of cardiology patients with poorer outcomes. A key issue is “nephrophobia,” manifested in the unjustifiably infrequent use of basic renoprotective therapy (ACEIs/ARBs) during hospitalization, which necessitates changes in the management approaches for this patient category.

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