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Status of vitamin D in difficult to treat cardiorenal syndrome in heart failure patients.

Session Poster Session 1

Speaker Naresh Sen

Event : Heart Failure 2018

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : N Sen (Jaipur,IN), SONAL Tanwar (Jaipur,IN), ASHOK Jain (Jaipur,IN)

N Sen1 , SONAL Tanwar2 , ASHOK Jain1 , 1Narayana Hrudayalaya, Cardiology - Jaipur - India , 2HG SMS Hospital, Cardiology - Jaipur - India ,


Background:  Decreased glomerular filtration rate(GFR)  is a potent predictor of cardiovascular mortality and complications. Worsening heart failure can accelerate worsening of renal function – the so-called cardiorenal syndrome. Risk factors include hypertension, diabetes, elderly age, and prior history of heart or renal failure.
Aims & Objectives:  To study the correlation between serum vitamin D values in uncontrolled cardiorenal syndrome and to evidential improvement in control of cardiorenal syndrome after vitamin D supplementation and correlate it with heart & renal function.
Methods: Serum vitamin D levels were assessed in 178 patients of cardiorenal syndrome in duration of 2 years (2015-2017) and we found very low level of vitamin D ( average level was 16 U ng/ml )  in 108 patients of difficult to treat cardiorenal syndrome between 19 -74 years of age who were uncontrolled even after courses of Betablocker, Diuretics and ACE inhibitors or Angiotensin II Receptor Blocker Neprilysin Inhibitor (ARNI) and other optimised medical therapy . These patients were treated with calcium and Vitamin D supplementation for 12 weeks  and after were re-evaluated with repeat vitamin D levels, Renal function test , GFR and Cardiac functions by 2D Echocardiography .
Results: All  108  patients showed significant improvements in B-type natriuretic peptide (BNP level), Right and Left ventricular function, LVEF incresed (14+/-4%) , decreased pulmonary capillary wedge pressure and improved class of dyspnea New York Heart Association IV to class II or III. After 3 months of vitamin D supplementation 43% patients had improved GFR and serum creatinine value as compare to placebo 16% , p value(<0.003).
Conclusion:  Study showed  a strong correlation between vitamin D deficiency and difficult to manage cardiorenal syndrome and good cardiorenal outcome after supplementation.

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