Klinički modaliteti kardiorenalnog sindroma i značaj pojedinih biomarkera u njihovoj proceni

Introduction: The cardio renal syndrome is a pathophysiological condition in which acute or chronic disfunction of an organ leads to acute or chronic damage of other organs. Objective: To compare the concentration and activity of the studied biomarkers of structural and functional damage to the heart and kidney, markers of inflammation and oxidative stress related to types of cardio renal syndrome and to determine their significance in certain clinical modalities of cardio renal syndrome. Methods: The study included 114 subjects older than 18 years, both sexes, divided into clinical and control group. The control group was consisted of 35 healthy subjects, male and female, who were of similar age and sex characteristics as the clinical group. With them on the basis of clinical and medical history, laboratory tests of functional excluded the existence of pathological process, prior to inclusion in the study. The study was designed as a comparative cross sectional study. The clinical group involved 79 subjects. The clinical group was divided into five subgroups, based on the current classification, into types of cardio renal syndrome. Results: By comparing basic hematological and biochemical parameters between subtypes of cardio renal syndrome were observed significant differences in the values of TIBC, urea, urinary albumin-creatin relationships, values of sodium, creatinine kinase and triglyceride levels. Significant differences were found in concentration of AOPP, PAI-1, cTnhsT, where in the concentration of troponin-responsive PAI-1 were the highest in patients in the first subgroup and the concentration of the AOPP I the second subgroup. A comparison of the investigated biomarkers among patients with acute in relation to chronic cardio renal syndrome, differences were found only at concentrations of CRP. As an independent factor for the occurrence of cardio renal syndrome type 1 were found to be cTnhsT and XOD activity and XD. For the development of cardio renal syndrome type 2 as an independent risk factor were found to be patient age, presence of high blood pressure, concentration of AOPP and MDA. From tested biomarkers as risk factor for cardio renal syndrome type 4 was allocated the concentration of PAI-1. For the formation of cardio renal syndrome type 5 were found to be the presence of diabetes, urinary albumin-creatinine ratio and concentration of cystatin C. Conclusion: The tested biomarkers are possible to determine the existence of a combined heart and kidney diseases. They are useful in distinguishing different types of cardio renal syndrome in clinical practice as well as in determining risk factors for the beginning of cardio renal syndrome