Clinical Profile and Determinants of Chronic Kidney Disease Progression in Patients With Cardiorenal Anaemia Syndrome in Tanzania: A Descriptive Post Hoc Prospective Observational Study.

Background and Aims: The burden of chronic kidney disease (CKD) progression remains notably high among patients with CKD, resulting to adverse clinical outcomes. However, there is scarcity of data on CKD progression in patients with cardiorenal anaemia syndrome (CRAS). This study aimed to examine the clinical profile and identity the determinants of CKD progression in patients with CRAS. Methods: We conducted a descriptive post-hoc prospective observational study using data from a previously completed prospective cohort study between August 2023 and April 2024 at the cardiology clinic of Benjamin Mkapa Hospital, Dodoma. Adult patients (≥ 18 years) diagnosed with CRAS were included. Baseline demographic and clinical data were analysed. CKD progression was determined based on changes in estimated glomerular filtration rate (eGFR) within 6 months. Determinants of CKD progression were determined and analysed. During exploratory analyses, both descriptive and inferential methods were employed. A statistical significance set at two-sided p-value < 0.05. Results: A total of 112 patients with CRAS with the mean age of 57.84 (14.53 S.D) years were analysed. At baseline, 54.5% (61/112) were ≤ 60 years, and 56.2% (63/112) being female. The median creatinine was 171 (96-351) mmol/L with a mean eGFR of 35.2 (14.46 SD) miL/min/1.73 m2. Most patients, 60.7% (68/112) were in CKD stage 3, and 51.8% (58/112) presented with moderate to severe increased albuminuria. Over the 6-month follow-up, CKD progression was observed in 53.57% (60/112). Determinants were included advanced age: 3.62 (95% CI, 1.35-9.65; p = 0.010); albuminuria: 2.78 (95% CI, 1.08-7.16; p = 0.034); poor functional cardiac status (NYHA class III/IV): 6.44 (95% CI, 2.04-20.27; p < 0.001) and iron deficiency: 9.11 (95% CI, 2.92-28.47; p < 0.001). Conclusion: There is high burden of CKD progression among patients with CRAS. Therefore, targeted intervention is beneficial to retard CKD progression in this high-risk population.