P0644RELATIONSHIP BETWEEN THE PRESENCE OF INFECTION DISEASE AND CLINICAL OUTCOMES OF PATIENTS WITH CARDIORENAL SYNDROME TYPE 1

Abstract Background and Aims: Introduction Cardiorenal Syndrome type 1 (CRS-1) can be triggered by an infection. The pathophysiological basis is vascular congestion, which is why it has been treated with different strategies of diuretics, but in the presence of infection, the inflammatory, neurohormonal and hemodynamic effects can compromise the efficacy of the diuretic therapy and potentially worsen clinical evolution. Here we compare the clinical evolution during the hospitalization of CRS-1 patients with and without infection. Method This is a retrospective cohort study conducted in the Hospital Civil of Guadalajara “Fray Antonio Alcalde”, from January 2015 to September 2018. Conducted in CRS-1 patients, we showed the clinical evolution and diuretic strategies analyzed according to the presence or absence of infection. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. Results We identified 63 patients classified as having CRS-1, 28 (44.4%) were classified as having an infectious disease. The mean age was 62 years (±14.6) and 58 (±12.4) in the group with infection and no infection, respectively. There were no statistically significant differences between the clinical outcomes of both groups. The median length of hospital stay was 8 days in the group with infection and 7 days in the group without infection (p=0.065). Three patients (10.7%) of the group with infection received renal replacement therapy and 1 patient (2.9%) in the group without infection (p=0.315). In the group with infection, 2 patients died (7.1%), whereas in the uninfected group there were no deaths (p=0.194). sCr values tend to diminish in a similar manner in both groups. Serum sodium tend to increase during the hospitalization but there was no significant difference between the groups. We found that all patients received furosemide at least during the first five days of hospitalization and the strategy of the diuretic chosen was similar between groups. Conclusion We showed that the clinical evolution of patients with CRS-1 is similar in the presence or absence of infection. We anticipate that this study may be a reason to expand knowledge in patients with CRS-1 and the presence of infection. Figure 1 serum creatinine at admission, intermediate and at discharge between two goups. Figure 2 Route of administration of diuretic treatment in the first 3rd to 7th day between two goups.