Cardiorenal Syndrome: An Underdiagnosed Pathology

Background: Cardiac Insufficiency (CI) is the primary cause of hospital admission in developed countries. The mortality rate is very high and often results in Cardiorenal Syndrome (1 in every 10 patients dies during admission). We conducted an observational study with the primary objective of investigating and assessing renal function in patients admitted with a diagnosis of CI, identifying those who meet the criteria for Cardiorenal Syndrome, and estimating its impact on patient prognosis. Methods: An observational retrospective study that included 664 patients admitted within one year for CI. Renal function data included Estimated Glomerular Filtration Rate (eGFR), creatinine levels, and proteinuria determination (median albuminuria or protein/creatinine ratio). Medical practices from different specialties were compared, and clinical outcomes, including mortality and readmission rate, were analyzed. Results: Out of the 664 evaluated patients, 100% of those attended by Nephrology had a complete renal function assessment. However, 44.1% of patients attended by other specialties did not have their eGFR determined. In 85.1% of cases, creatinine levels were determined, but albuminuria was requested in less than 5%. Mortality in the ICU was 10%, and 20% of patients were readmitted within the year. Only 3% of patients with elevated creatinine levels were referred to Nephrology, and eGFR or albuminuria were valued by Nephrology in less than 10% of cases referred to the Cardiorenal Unit. Conclusion: More than half of the patients with CI do not receive optimal renal function assessment. The low rate of albuminuria evaluation is concerning due to its role in cardiovascular risk. Other conclusions from this study are that Cardiorenal Syndrome is underdiagnosed. It is crucial to have a multidisciplinary early referral approach to Cardiorenal Units for better prognosis and quality of life for these patients.