Disorders of Kidney Function in Chronic Heart Failure

Abstract

The formation of cardiorenal syndrome (CRS) in patients with chronic heart failure (CHF) is a natural manifestation of a functionally interrelated process at the organ level. Moreover, impaired renal function is a common and independent factor in the progression of the disease, a high incidence of cardiovascular events and death in a population of patients with asymptomatic and / or clinically manifested CHF, which is due to the pathogenetic features of the formation of cattle in patients with CHF of ischemic genesis. The article provides an overview of studies on the pathogenesis of kidney damage in CHF, the role of various markers in the early diagnosis of cattle. A decrease in glomerular filtration rate (GFR) and an increase in urinary albumin excretion are currently considered as "renal" markers of a poor prognosis within the cardiorenal continuum. In this regard, for stratification of patients by stages of chronic kidney disease (CKD) and, consequently, for assessing the risks of increased overall and cardiovascular mortality in patients with CHF, the accuracy of calculating GFR, as the main indicator reflecting the severity of formed kidney damage, is of great importance. Microalbuminuria is one of the early signs of CKD, the main cause of which is glomerular capillary endothelial dysfunction that occurs in most patients with CHF. The presence and persistence of subclinical renal dysfunction during treatment, even with the achievement of risk factors (RF) control and regression of organ lesions, can adversely affect the patient's prognosis. Assessment of the functional state of the kidneys is important for early diagnosis, selection of effective preventive measures and treatment. The therapeutic strategy in patients with CHF in combination with CKD should be based on the nephroprotective effects of drugs.