Article Dans Une Revue Archives of cardiovascular diseases Année : 2024

Cardiogenic shock and chronic kidney disease: Dangerous liaisons

1 UPS/Inserm U1297 - I2MC - Institut des Maladies Métaboliques et Casdiovasculaires
2 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
3 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
4 HEGP - Hôpital Européen Georges Pompidou [APHP]
5 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
6 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
7 CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux]
8 Hôpital Haut-Lévêque [CHU Bordeaux]
9 Hôpital Nord [CHU - APHM]
10 MARS cardio - Mediterranean Association for Research and Studies in Cardiology
11 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
12 IMRB - Institut Mondor de Recherche Biomédicale
13 CHU Henri Mondor [Créteil]
14 CH de Saint-Malo [Broussais]
15 Nouvel Hôpital Civil de Strasbourg
16 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
17 Hôpital Louis Pasteur [Chartres]
18 CHU Nice - Centre Hospitalier Universitaire de Nice
19 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
20 TIMONE - Hôpital de la Timone [CHU - APHM]
21 AMU - Aix Marseille Université
22 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
23 CHU Tenon [AP-HP]
24 CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
25 Hôpital de la Croix-Rousse [CHU - HCL]
26 CHUGA - CHU de Grenoble-Alpes - Centre Hospitalier Universitaire CHU Grenoble
27 CHU Clermont-Ferrand
28 UCA - Université Clermont Auvergne
29 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
30 UM - Université de Montpellier
31 LTSI - Laboratoire Traitement du Signal et de l'Image
32 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
33 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
34 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
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Résumé

Background: Chronic kidney disease (CKD) is one of the leading causes of death worldwide, closely interrelated with cardiovascular diseases, ultimately leading to the failure of both organs - the so-called "cardiorenal syndrome". Despite this burden, data related to cardiogenic shock outcomes in CKD patients are scarce.Methods: FRENSHOCK (NCT02703038) was a prospective registry involving 772 patients with cardiogenic shock from 49 centres. One-year outcomes (rehospitalization, death, heart transplantation, ventricular assist device) were analysed according to history of CKD at admission and were adjusted on independent predictive factors.Results: CKD was present in 164 of 771 patients (21.3%) with cardiogenic shock; these patients were older (72.7 vs. 63.9years) and had more comorbidities than those without CKD. CKD was associated with a higher rate of all-cause mortality at 1month (36.6% vs. 23.2%; hazard ratio 1.39, 95% confidence interval 1.01-1.9; P=0.04) and 1year (62.8% vs. 40.5%, hazard ratio 1.39, 95% confidence interval 1.09-1.77; P<0.01). Patients with CKD were less likely to be treated with norepinephrine/epinephrine or undergo invasive ventilation or receive mechanical circulatory support, but were more likely to receive renal replacement therapy (RRT). RRT was associated with a higher risk of all-cause death at 1month and 1year regardless of baseline CKD status.Conclusions: Cardiogenic shock and CKD are frequent "cross-talking" conditions with limited therapeutic options, resulting in higher rates of death at 1month and 1year. RRT is a strong predictor of death, regardless of preexisting CKD. Multidisciplinary teams involving cardiac and kidney physicians are required to provide integrated care for patients with failure of both organs.

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hal-04544818 , version 1 (15-07-2024)

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Miloud Cherbi, Eric Bonnefoy, Etienne Puymirat, Nicolas Lamblin, Edouard Gerbaud, et al.. Cardiogenic shock and chronic kidney disease: Dangerous liaisons. Archives of cardiovascular diseases, 2024, 117 (4), pp.255-265. ⟨10.1016/j.acvd.2024.01.006⟩. ⟨hal-04544818⟩
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