Determination of the CRS1 Incidence in ADHF Patients with Identification of Its Independent Predictors and Evaluation of the Clinical Outcomes among the Patients

Abstract

Background: Cardiorenal syndrome type 1 (CRS1) complicates the course and prognosis of patients hospitalized with acute decompensated heart failure. This study aimed to determine the incidence, independent risk factors, and short-term outcomes of CRS1 in a Saudi Arabian cohort. Methods: We retrospectively analyzed patients admitted with acute decompensated heart failure over five years at a tertiary care hospital. Demographic, clinical, and laboratory data were reviewed to identify predictors of CRS1 and six-month outcomes. Management patterns, including the use of guideline-directed medical therapy, and rates of renal recovery were assessed. Results: Among 314 patients, CRS1 occurred in 51.2%. Independent risk factors were CKD, hypertension, prior AKI, and COPD. At six months, patients with CRS1 had numerically higher mortality (53.7%) and rehospitalization rates (60%) than patients without CRS1, although these differences were not statistically significant. However, rehospitalization within two months was more common (p= 0.16), and hospital stay was significantly longer for CRS1 patients (p=0.002). Complete renal recovery was achieved in 84 individuals (52.2%) of CRS1 cases, which strongly correlated with favorable outcomes. All patients received diuretics, while ultrafiltration was rarely used. Conclusion: CRS1 is common among patients hospitalized with acute decompensated heart failure and is associated with adverse short-term outcomes, particularly when renal recovery is incomplete. Early identification of high-risk patients and optimized heart failure management are essential. Larger prospective studies with extended follow-up are warranted to refine long-term care strategies.