Determination of the CRS1 Incidence in ADHF Patients with Identification of Its Independent Predictors and Evaluation of the Clinical Outcomes among the Patients
Elbadri I. Abdelgadir *
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia and King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia.
Yaqob S. Taleb
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia, King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia and College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), AlAhsa, Saudi Arabia.
Nahaa E. Alsubaie
Department of Mathematics and Statistics, University College of Khurma, Taif University, Taif, Saudi Arabia.
Waleed Gado
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia and King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia.
Khamess O. Khamees
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia and King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia.
Lulwah Al Turki
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia, King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia and College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), AlAhsa, Saudi Arabia.
Muneera O. AlTaweel
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia and King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia.
Ramy I. Abulikailik
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia and King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia.
Ayman F. Soliman
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia, King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia and College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), AlAhsa, Saudi Arabia.
Mohammed A. Kaballo
King Abdulaziz Hospital, Ministry of National Guard Health Affairs (MNGHA), AlAhsa, Saudi Arabia and King Abdullah International Medical Research Center (KAIMRC), AlAhsa, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Background: Cardiorenal syndrome type 1 (CRS1) complicates the course and prognosis of patients hospitalized with acute decompensated heart failure. This study aimed to determine the incidence, independent risk factors, and short-term outcomes of CRS1 in a Saudi Arabian cohort.
Methods: We retrospectively analyzed patients admitted with acute decompensated heart failure over five years at a tertiary care hospital. Demographic, clinical, and laboratory data were reviewed to identify predictors of CRS1 and six-month outcomes. Management patterns, including the use of guideline-directed medical therapy, and rates of renal recovery were assessed.
Results: Among 314 patients, CRS1 occurred in 51.2%. Independent risk factors were CKD, hypertension, prior AKI, and COPD. At six months, patients with CRS1 had numerically higher mortality (53.7%) and rehospitalization rates (60%) than patients without CRS1, although these differences were not statistically significant. However, rehospitalization within two months was more common (p= 0.16), and hospital stay was significantly longer for CRS1 patients (p=0.002). Complete renal recovery was achieved in 84 individuals (52.2%) of CRS1 cases, which strongly correlated with favorable outcomes. All patients received diuretics, while ultrafiltration was rarely used.
Conclusion: CRS1 is common among patients hospitalized with acute decompensated heart failure and is associated with adverse short-term outcomes, particularly when renal recovery is incomplete. Early identification of high-risk patients and optimized heart failure management are essential. Larger prospective studies with extended follow-up are warranted to refine long-term care strategies.
Keywords: Cardiorenal syndrome, heart failure, mortality, risk factors