ALTERATION IN RENAL FUNCTION FOLLOWING LOOP DIURETICS IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

Objective: The objective of the study was to monitor the impact of loop diuretic therapy in patients with acute decompensated heart failure (ADHF) and to assess other predictors of renal dysfunction in patients with ADHF. Methods: An observational study over a period of 6 months from January 2018 to June 2018 in the Department of Cardiology, in a Tertiary Care Teaching Hospital, Coimbatore, Tamil Nadu. Patients on diuretic therapy (loop diuretic) were enrolled. Patients with prior chronic kidney disease were excluded from the study. The patients were evaluated based on change in serum creatinine (SCr) and other contributing factors were assessed by acute kidney injury network and worsening of renal function criteria. Results: A total of 135 patients were enrolled, of which 73% were males and 27% were females. The mean age of the subjects was 61.55±13 years. The baseline means SCr was 1.62±0.92 mg/dl. On evaluation, 41% were really affected and 59% remain unaffected. Factors such as hypertension (p=0.047) and angiotensin-converting enzyme inhibitors (ACE-I) (p=0.023) were found to be significant predictors of renal injury. Conclusion: Variation in renal function in ADHF patients was multifactorial. The direct influence of loop diuretics on renal function was present but was not well established. Hypertension and ACE-I have found to show influence in the development of renal injury as contributing factors. There exists both positive and negative consequence of loop diuretics on renal function