• Muhammad Khan
  • Waqas Jehangir
  • Muhammad Salman Daood
  • Ahmad Khan
  • Nadeem Hayat Mallick


Background: Heart Failure (HF) is a common disease with a high mortality rate. Anaemia and renalfailure (RF) are often present in patients with HF and associated with worse prognosis. Objective of studywas to evaluate the prevalence of anaemia and RF in patients with HF. Methods: Patients admitted inPunjab institute of cardiology Lahore with diagnosis of heart failure were enrolled from February, 2008 toDecember, 2008. Anaemia was defined as haemoglobin levels <13 mg/dl for men and 12 mg/dl forwomen. Renal function was assessed by the glomerular filtration rate (GFR), calculated by the simplifiedformula of the MDRD (Modification of Diet in Renal Disease) study. Results: Of the 276 patientsincluded in this study, 42.03% (116) had anaemia and 38.40% (106) had moderate to severe renal failure(GFR <60 ml/min). Conclusion: The prevalence of anaemia and renal failure was high in this populationand was associated with the severity of the HF (functional classes III and IV).Keywords: Heart failure, anaemia, renal insufficiency


Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda

M, et al. Guidelines for the diagnosis and treatment of chronic

heart failure: executive summary (update 2005): The Task Force

for the Diagnosis and Treatment of Chronic Heart Failure of the

European Society of Cardiology. Eur Heart J 2005;26:1115–40.

Sales ALF, Villacorta H, Reis L, Mesquita ET. Anemia as a

prognostic factor in a population hospitalized due to

decompensated heart failure. Arq Bras Cardiol 2005;84:237–40.

Hillege HL, Nitsch D, Pfeffer MA, Swedberg K, McMurray JJ,

Yusuf S, et al. Renal function as a predictor of outcome in a broad

spectrum of patients with heart failure. Circulation 2006;113:671–8.

Silverberg DS, Wexler D, Blum M, Wollman Y, Iaina A. The

cardio-renal syndrome: does it exist? Nephrol Dial Transplant.

;18(Suppl.8): viii7–viii12.

Gil P, Justo S, Caramelo C. Cardio-renal failure: an emerging

clinical entity. Nephrol Dial Transplant. 2005;20:1780–3.

Silverberg D. Outcomes of anaemia management in renal

insufficiency and cardiac disease. Nephrol Dial Transplant

;18(Suppl 2):ii7–ii12.

Lindenfeld J. Prevalence of anemia and effects on mortality in

patients with heart failure. Am Heart 2005;149:391–401.

Tang Y, Katz SD. Anemia in chronic heart failure: prevalence,

etiology, clinical correlates, and treatment options. Circulation


Silverberg DS, Wexler D, Blum M, Keren G, Sheps D,

Leibovitch E, et al. The use of subcutaneous erythropoietin and

intravenous iron for the treatment of the anemia of severe,

resistant congestive heart failure improves cardiac and renal

function and functional cardiac class, and markedly reduces

hospitalizations. J Am Coll Cardiol 2000;35:1737–44.

Tanner H, Moschovitis G, Kuster GM, Hullin R, Pfiffner D, Hess

OM, et al. The prevalence of anemia in chronic heart failure. Int J

Cardiol 2002;86:115–21.

Anand I, McMurray JJV, Whitmore J, Warren M, Pham A,

McCamish MA, et al. Anemia and its relationship to clinical

outcome in heart failure. Circulation 2004;110:149–54.

O'Meara E, Clayton T, McEntegart MB, McMurray JJ, Lang CC,

Roger SD, et al. Clinical correlates and consequences of anemia

in a broad spectrum of patients with heart failure: results of the

Candesartan in Heart Failure: Assessment of Reduction in

Mortality and Morbidity (CHARM) Program. Circulation


Latado AL, Passos LC, Darze ES, Lopes AA. Comparison of the

effect of anemia on in-hospital mortality in patients with versus

without preserved left ventricular ejection fraction. Am J Cardiol.


Felker GM, Adams KF Jr, Gattis WA, O'Connor CM. Anemia as

a risk factor and therapeutic target in heart failure. J Am Coll

Cardiol 2004;44:959–66.

Silverberg DS, Wexler D, Blum M, Schwartz D, Wollman Y,

Iaina A. Erythropoietin should be part of congestive heart failure

management. Kidney Int 2003;87(Suppl):S40–7.

Opasich C, Cazzola M, Scelsi L, De Feo S, Bosimini E, Lagioia

R, et al. Blunted erythropoietin production and defective iron

supply for erythropoiesis as major causes of anaemia in patients

with chronic heart failure. Eur Heart J 2005;26:2232–7.

Androne AS, Katz SD, Lund L, LaManca J, Hudaihed A,

Hryniewicz K, et al. Hemodilution is common in patients with

advanced heart failure. Circulation 2003;107:226–9.

Westenbrink BD, Visser FW, Voors AA, Smilde TD, Lipsic E,

Navis G, et al. Anaemia in chronic heart failure is not only related

to impaired renal perfusion and blunted erythropoietin production,

but to fluid retention as well. Eur Heart J 2007;28:166–71.

Silverberg DS, Wexler D, Sheps D, Blum M, Keren G, Baruch R,

et al. The effect of correction of mild anemia in severe, resistant

congestive heart failure using subcutaneous erythropoietin and

intravenous iron: a randomized controlled study. J Am Coll

Cardiol 2001;37:1775–80.

Mancini DM, Katz SD, Lamanca J, Hudaihed A, Androne AS.

Effect of erythropoietin on exercise capacity in patients with

moderate to severe chronic heart failure. Circulation


Bolger AP, Bartlett FR, Penston HS, O'Leary J, Pollock N,

Kaprielian R, et al. Intravenous iron alone for the treatment of

anemia in patients with chronic heart failure. J Am Coll Cardiol


Silverberg DS, Wexler D, Blum M, Tchebiner JZ, Sheps D,

Keren G, et al. The effect of correction of anaemia in diabetics

and non-diabetics with severe resistant congestive heart failure

and chronic renal failure by subcutaneous erythropoietin and

intravenous iron. Nephrol Dial Transplant 2003;18(1):141–6.

Silverberg DS, Wexler D, Iaina A, Steinbruch S, Wollman Y,

Schwartz D. Anemia, chronic renal disease and congestive heart

failure—the cardio renal anemia syndrome: the need for

cooperation between cardiologists and nephrologists. Int Urol

Nephrol 2006;38:295–310.




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