Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Changes in kidney function in heart failure patients convey important prognostic information. We investigated the role of the urea-to-creatinine (BUN/Cr) ratio and subsequent declines in kidney function in acute decompansated heart failure patients, the fractional excretion of urea (FeUr), and the fractional excretion of sodium (FeNa) also be investgated. We prospectively enrolled adult patients with ejection fraction (EF) < 40% at ICU units and measured serial measurements of laboratory values from June 2015 to march 2016. The study outcome was changes in the estimated glomerular filtration rate (eGFR). In 54 patients contributing follow-up outcome of ADHF, we found that The mean eGFR at baseline was 57.58 ± 13.92 mL min⁻¹1.73 m⁻² the mean base line of BUN / Cr ratio, FeUr, and FeNa were 50.13 ± 5.69 mL / min⁻¹1.73m⁻² , 37.42 ± 5.18%, and 0.83 ± 0.10% respectively. Our study showed that there was a negative correlation between GFR1 and FeNa1, FeUr1. and there was a positive correlation between GFR1 and U-C Ratio1 however stat nonsignificant. There was a positive correlation between (GFR2 and FeNa 2) (P = 0.000), (GFR3 and FeNa3) (P = 0.000), and also between (GFR3 and FeUr3, U-C ratio3 (P = 0.000)). and there was a negative correlation between GFR2 and FeUr2 (P = 0.001), U-C ratio 2 (P = 0.008) . In our study there was a non significant correlation between NYHA score and FeNa 2 and U-C ratio 2 but there was a significant correlation between NYHA score and GFR2 and FeUr2 also there was a highly significant correlation between NYHA score and GFR3, FeNa3 , FeUr3 andU-C ratio3

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