The addition of renal dysfunction to chronic heart failure (CHF) worsens the prognosis and increases the treatment cost. With renal function decreasing, the cardiovascular risk increases, and therefore the prevention of further decline should be an independent management goal. In the face of resource shortages, it is important to identify patients who are at risk for glomerular filtration rate (GFR) deterioration for close monitoring and timely treatment correction. Aim. То identify and evaluate the contribution of predictors in renal function decline in the elderly with CHF on the background of hypertension (AH) and chronic kidney disease. Objects and methods. The study included 122 patients aged 60 to 74 years with CHF on the background of AH and GFR EPI> 45 ml/min/1,73 m2 . The study consisted of 3 stages: at admission to the hospital, after 6 and 12 months after it. Patients underwent a general clinical study, creatinine assessment followed by glomerular filtration rate estimation according to the Chronic Kidney Disease Epidemiology Collaboration formula (GFR EPI), a 6-minute walk test (6MWT), and an assessment with Morisky Green Medication Adherence Scale. ROC and logistic analysis were used in the work. Results. During the study, changes in GFR EPI was 3,4 [-0,9; 7,1] ml/min/1,73 m2 . Most of the patients – 68.8% (64/93), had an increase of GFR EPI after a year of follow-up. Deterioration of GFR EPI occurred in 29% (27/93) of patients with a mean reduction among them of -3.3 [-5.8; -1.7] ml/min/1,73 m2 . After adjusting for the level of medication adherence, the statistically significant influence on renal function decline had the next variables: categorical variables obtained by ROC analysis – 6MWT(2 visit)cat≤321 m (OR 3,98, 95% CI 1,32-11,99) and GFR EPI (2 visit)cat≤59,9 ml/ min/1,73 m2 (OR 3,06, 95% CI 1,09-8,54), as well as lung crackles on auscultation (OR 2,99, 95% CI 1,03-8,62) and hospitalization during the first (OR 5,76, 95% CI 1,81-18,26) and the second (OR 4,42, 95% CI 1,45-13,48) half-year. Conclusions. According to the results of multiple logistic analysis, the predictors of renal function decline were 6MWT, GFR EPI, crackles over the lungs, as well as hospitalization in the first and second half-year of the observation. All of them remained statistically significant regardless of medication adherence level.
«Bulletin of problems biology and medicine» Issue 4 (162), 2021 year, 204-208 pages, index UDK 616.61-008-037:616.12-008.46-036.1-008.331.1
