Cardio Renal Syndrome at the Mohammed VI University Hospital of Marrakech: Epidemiological, Clinical, Therapeutic and Evolutionary Aspects

Introduction: Cardiorenal syndrome (CRS) is an entity involving a bidirectional pathophysiological interaction between the heart and the kidneys. This interaction includes either chronic or acute dysfunction of one organ, which could induce chronic or acute dysfunction of the other. It leads to higher morbidity and mortality rates. The aim of this study is to estimate the prevalence of the different types of CRS and identify the main epidemiological, clinical, therapeutic, and prognostic aspects of this syndrome. Methods: Our study was a retrospective, descriptive, and analytical investigation conducted over three years, including all heart failure patients with impaired renal function who were hospitalized in the cardiology and nephrology departments between January 2021 and January 2024. Results: Our population included 206 patients, with a male predominance of 60.5%. The average age of our patients was 65 years ± 14. The clinical presentation was characterized by dyspnea (86.4%) and crackles (38.3%). The majority of our patients had preserved diuresis (84,7%). Echocardiography mostly revealed left ventricular systolic dysfunction (78%), and a dilated left ventricle in 49.5% of cases. Normal-sized kidneys were observed in 86% or our patients on ultrasound. Renal replacement therapy was needed in 16% of the cases. Complete recovery of renal function was observed in 40.8% of patients, with an average discharge creatinine level of 20 mg/L. The dominant type of CRS was type 1 (59.2%), with ischemic heart disease (48.5%) as the leading etiology. Thirty-five deaths (17%) were recorded. The use of vasoactive amines was correlated with a higher mortality rate (p < 0.001), unlike the need for dialysis and prolonged hospitalization. Conclusion: Cardiorenal syndrome is a multifaceted condition, often complex to understand. It represents a significant public health issue. Therefore, gaining a deeper understanding of its pathophysiology will enable structured management and le