Renal function in patients with anemia and severe chronic heart failure: effects of iron medications

Aim. To investigate the prevalence of anemia and renal dysfunction combination among patients with severe chronic heart failure (CHF), as well as the effects of intravenous (i/v) iron therapy. Material and methods. In total, 42 patients (mean age 69,3 +/- 1,2 years) with Functional Class III-IV stable CHF (NYHA classification) were examined. Glomerular filtration rate (GFR) was calculated based on creatinine concentration (MDRD formula). Anemia was diagnosed by WHO criteria: hemoglobin (Hb) level < 130 g/l in men and < 120 g/l in women. Eleven patients were administered Venofer for 24 weeks. At baseline and after the treatment course, 6-minute walk test (6mw) was performed. Results. Anemia was diagnosed in 17 (40,5%) patients, including 13 with iron deficiency. Chronic renal failure (CRF; GFR < 60 ml/min) was observed in 64,7% of the participants. Clinical and laboratory parameters were compared in patients with cardiorenal syndrome (GFR < 60 ml/min) with or without anemia. Significant negative correlation was observed between Hb and creatinine levels (p=-0,02), with positive correlation between hematocrit (Ht) and GFR levels (p=0,044). Intravenous iron therapy was associated with a significant increase in Hb (from 128,2 +/- 14,4 to 139,0 +/- 17,4 g/l; p=0,03), Ht (from 38,4 +/- 3,5 to 41,3 +/- 5,06; p=0,03), and physical stress tolerance (PST), according to 6mw test results. Conclusion. The combination of cardiac pathology, renal dysfunction and iron-deficient anemia was typical of patients with severe CHF Iron therapy was associated with significant increase in Hb, Ht, and PST levels, without any severe adverse effects.