Laboratory predictors of chronic kidney disease progression in patients with heart disease

Aim. To identify markers of chronic kidney disease (CKD) progression in elderly individuals with chronic ischemic heart disease (CHD). Materials and Methods. The study included 100 patients with a mean age of 70.2 ± 4.1 years with coronary heart disease. 55 (55,0%) women and 45 (45,0%) men participated in the study. All patients had signs of chronic heart failure (CHF) not higher than functional class (FC) II according to the New York Heart Association (NYHA) and no history of kidney disease. Besides, the patients had comorbid conditions, including diabetes mellitus (DM) in 20 (20,0%) patients, arterial hypertension (AH) in 94 (94,0%) patients, and obesity in 24 (24,0%) patients. CKD was diagnosed using the KDIGO criteria. The laboratory tests included general clinical and biochemical parameters in the serum and urine, as well as levels heart failure markers (brain-derived natriuretic peptide (NT-proBNP)). The statistical processing of the findings was carried out using the STATISTICA 12.0 package (StatSoft Inc., license number AXXR012E829129FA), MedCalc and Microsoft Excel. Results. Multiple regression and the ODDs Ratio method enabled us to establish a set of criteria for renal impairment progression (p < 0,05) in patients with chronic ischemic heart disease (CHD): biochemical analysis data included levels of cystatin C, total cholesterol, low-density lipoprotein cholesterol, lipoprotein (a), and NT-proBNP in the serum, and daily urine protein levels; clinical data included a history of hypertension, myocardial infarction, angina pectoris, and CHF. Conclusion: The study results support the need to use a combination of markers available in routine clinical practice to successfully prevent CKD progression, rather than relying on traditional indicators.