The role of ankle-brachial index in predicting of renal function recovery in the case of cardiorenal syndrome

Cardiorenal syndrome (CRS) is defined as progressive, combined cardiac and renal dysfunction. An ankle brachial index (ABI) is a marker of arterial stiffness. Research has demonstrated that a low ABI is associated with worse outcomes in patients with heart failure. Moreover, there is growing interest in the link between a reduced ABI and the development of CRS. As CRS represents a complex interaction between cardiac and renal dysfunction, early detection through ABI measurement could provide crucial insights into disease progression and facilitate timely therapeutic interventions. We aimed to investigate the recovery of renal function of patients hospitalized with acute decompensated heart failure (ADHF) and CRS. ABI was prospectively measured in 37 patients hospitalized due to ADHF with CRS resulting in renal replacement treatment (RRT) initiation. The mean age was 63 years. The patients were stratified into
three groups:
1. with clinical chronic kidney disease (CKD) (N = 17),
2. without clinical CKD but with abnormal (< 0.9) ABI (N = 13),
3. without clinical CKD with normal ABI (N =7).
Patients were prospectively followed for 90-days renal function recovery (RFR). At day 90, RFR was registered in 16 patients, such that CKD patients with abnormal ABI had the lowest rate (group 1), accordingly followed by group 2 and group 3 (3.5, 6.8, and 8.1%, respectively, p for trend = 0.009). As CRS represents a complex interaction between cardiac and renal dysfunction, early detection through ABI measurement could provide crucial insights into disease progression and facilitate timely therapeutic interventions.