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Article Dans Une Revue Archives of cardiovascular diseases Année : 2024

Cardiogenic shock and chronic kidney disease: Dangerous liaisons

Eric Bonnefoy
  • Fonction : Auteur
Bruno Levy
  • Fonction : Auteur
Laura Muller
  • Fonction : Auteur
Hamid Merdji
Grégoire Range
Emile Ferrari
  • Fonction : Auteur
Meyer Elbaz
Hadi Khachab
  • Fonction : Auteur
Jeremy Bourenne
  • Fonction : Auteur
Marie-France Seronde
  • Fonction : Auteur
Nans Florens
Guillaume Schurtz
Vincent Labbé
  • Fonction : Auteur
Gerald Vanzetto
  • Fonction : Auteur
Nicolas Combaret
Benjamin Marchandot
  • Fonction : Auteur
Benoit Lattuca

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 (13-04-2024)

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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, ⟨10.1016/j.acvd.2024.01.006⟩. ⟨hal-04544818⟩
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