PATHOGENETIC MECHANISM OF THE DEVELOPMENT OF DISORDERS OF KIDNEY FUNCTION ON THE BACKGROUND OF HEART FAILURE
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i1.15254Keywords:
heart failure, renal dysfunction, glomerular filtration rate, predictorsAbstract
SUMMARY. A high frequency of concomitant diseases is a characteristic feature of chronic heart failure (CHF), which can affect its development and progression. One of the most important comorbid conditions in CHF is renal dysfunction (RD), which plays a significant role in the pathogenesis of CHF. The prevalence of this condition varies from 42 % to 76 %. To better understand the pathogenetic mechanisms underlying renal dysfunction in chronic heart failure (CHF), it is important to identify and evaluate predictors of the development of renal dysfunction in patients with CHF.
The aim – to conduct a comparative analysis of groups of hemodynamically stable patients with chronic heart failure (CHF), with and without renal dysfunction, according to the main clinical and instrumental indicators.
Material and Methods. 60 patients with verified CHF and reduced left ventricular ejection fraction (LVEF) were examined, of which 30 patients with CHF and reduced LVEF without renal dysfunction (15 men, 15 women) and 30 patients with CHF and reduced LVEF with impaired function kidneys (19 men, 11 women). The average age of patients was 65±5 years. The control group included 30 practically healthy persons of the appropriate age and sex.
Results. Studies have shown that among hemodynamically stable patients with heart failure (HF) and reduced left ventricular ejection fraction, significantly lower values of glomerular filtration rate (GFR) were observed in NYHA class III-IV patients. Also, more pronounced changes in indicators were found in CHF patients with LVEF and impaired kidney function.
Conclusions. Patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF) who have renal dysfunction (RD) exhibit a significantly worse survival prognosis over a 28.5-month observation period compared to patients without this diagnosis. This difference persists even after adjusting for age and NYHA class.
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