Of the 180 heart failure patients that were enrolled in the study, the mean age of the participants was 62.26 ± 14 years. The maximum age of our respondents was 92 years while the minimum age of our respondents was 20 years. Regarding the age group, patients aged between 61–80 years was the most abundant participants (n = 87, 48.3%). The other common age groups in our study were 41–60 years old with (n = 66, 36.7%), > 80 years, 26–40 years, 18–25 years with a frequencies of (n = 13, 7.2%), (n = 12, 6.7%), and (n = 2, 1.1%), respectively. Of the 180 participants, 56.7% of them (n = 102) were males while 43.3% (n = 78) were females (Table 1).
Table 1
Demographic characteristics among our patients
Age (years) | Frequency(n) | Percentage (%) |
18–25 | 2 | 1.1 |
26–40 | 12 | 6.7 |
41–60 | 66 | 36.7 |
61–80 | 87 | 48.3 |
> 80 | 13 | 7.2 |
Gender | | |
Male | 102 | 56.7 |
Female | 78 | 43.3 |
Co-morbidities | | |
Hypertension | 106 | 59 |
CAD | 50 | 28 |
Diabetes mellitus | 45 | 25 |
Hyperlipidemia | 42 | 23.3 |
Smoking | 36 | 20 |
Obesity | 30 | 17 |
COPD | 15 | 8.3 |
Type of heart faiure |
HFpEF | 85 | 47 |
HFrEF | 63 | 35 |
HFmrEF | 32 | 18 |
CAD = coronary artery disease, COPD = chronic obstructive pulmonary disease, HFmrEF = heart failure with mid-range ejection fraction, HFpEF = heart failure with preserved ejection fraction, HFrEF = heart failure with reduced ejection fraction, N = number of patients |
Regarding the type of heart failure in our study, HFpEF was the most common type in our respondents with frequency of (n = 85, 47.2%), followed by HFrEF and HFmrEF with frequency of (n = 63, 35%) and (n = 32, 17.8%), respectively. Regarding the age groups; HFpEF and HFmrEF were more common in 61–80 years old patients with (51%) and (56%), while HFrEF was mostly found in 41–60 years old patients with (43%) (Table 1).
In this study, we found that the prevalence of renal dysfunction in heart failure patients to be 20.6% (n = 37). The remaining of our respondents (n = 143, 79.4%) had normal renal function. Our analysis showed that among the 37 respondents that were having renal dysfunction, 12.3% of them (n = 22) were chronic renal failure while the remaining 8.3% (n = 15) had acute renal failure. Out of the 37 heart failure patients with renal dysfunction, (n = 30, 81%) of them were males while the remaining (n = 7, 19%) were females. Acute renal failure and chronic renal failure were both observed to be more common in males, patients with HFrEF, and patients with co-morbidities, with (93% vs 73%), (47% vs 55%), (80% vs 95%), respectively. We found a significant correlation between gender and renal dysfunction in heart failure patients with (95% CI: 0.098–0.574, OR: 0.237, p value: <0.001). Males with heart failure were 2 and half times more likely to develop renal failure than females (Table 2).
Table 2
The rate of renal dysfunction among heart failure patients according to demographic variables.
Age (years) | Non renal dysfunction | Acute renal dysfunction | Chronic renal dysfunction | Total patients | (95% CI) | Odds ratio | p Value |
18–25 | 1 (1%) | 1 (7%) | 0 (0%) | 2 (1%) | 0.738–1.937 | 1.196 | < 0.468 |
26–40 | 7 (5%) | 2(13%) | 3 (14%) | 12 (7%) |
41–60 | 55 (38%) | 4 (27%) | 7 (32%) | 66 (37%) |
61–80 | 70 (49%) | 6 (40%) | 11 (50%) | 87 (48%) |
> 80 | 10 (7%) | 2 (13%) | 1 (4%) | 13 (7%) |
Sex |
Male | 72 (50.3%) | 14 (93%) | 16 (73%) | 72 (50.3%) | 0.098–0.574 | 0.237 | < 0.001** |
Female | 71 (49.6%) | 1 (7%) | 6 (27%) | 78 (43%) |
** means statistically significant co-relation, CI = confidence interval |
The co-morbidities of the patients were assessed; the most common co-morbidity was hypertension (n = 106, 59%), followed by coronary artery diseases (n = 50, 28%), diabetes mellitus (n = 45, 25%), and hyperlipidemia (n = 42, 23.3%). The least common of co-morbidity in our patients was COPD (n = 14, 8.8%). Patients who are obese, those with a history of smoking, hypertension, coronary artery disease, and obesity were found to be more common to have chronic renal failure with (100%), (67%), (57%), (54%), respectively (Table 3). When analyzed the causes of heart failure among patients; hypertension was the most common cause of heart failure (n = 90, 50%), while ischemic heart disease, valvular heart disease and cardiomyopathy were (n = 52, 28.9%), (n = 31, 17.2%), (n = 7, 3.9%), respectively. Hypertension was also the most common cause of heart failure in all age groups except 41–60 years old patients. The most common cause of heart failure among these patients was ischemic heart disease. (Fig. 1)
Table 3
Distribution of co-morbidities according renal impairment in heart failure patients
Co-morbidities | Non renal dysfunction | Acute renal dysfunction | Chronic renal dysfunction | Total patients | (95% CI) | Odds ratio | p Value |
Diabetic | 34(24%) | 6(40%) | 5(23%) | 45 | 0.330–1.646 | 0.737 | < 0.457 |
Hypertensive | 85(59%) | 9(60%) | 12(55%) | 106 | 0.536–2.467 | 1.149 | < 0.721 |
History of CAD | 37(35%) | 6(40%) | 7(32%) | 50 | 0.259–1.365 | 0.594 | < 0.220 |
Hyperlipidemia | 35(24%) | 4(27%) | 3(14%) | 42 | 0.682–4.732 | 1.797 | < 0.236 |
Smoking | 27(75%) | 3(8%) | 6(17%) | 36 | 0.333–1.984 | 0.813 | < 0.649 |
Obesity | 25(83%) | 0(0%) | 5(17%) | 30 | 0.525–4.431 | 1.525 | < 0.438 |
COPD | 14(93%) | 0(0%) | 1(7%) | 15 | 0.532–35.037 | 4.317 | < 0.171 |
CAD = coronary arterial disease, CI = confidence interval, COPD = chronic obstructive pulmonary disease |