Cardiorenal syndrome in patients with type 2 diabetes and hypertension
The aim of the research is evaluation of cardiac and renal dysfunction in patients with type 2 diabetes mellitus, hypertension and in case two nosologies are combined, clinical and functional features of patients with cardiorenal syndrome. Material and methods. 231 people were examined. All the studied were divided into 7 groups: 1 group - patients with type 2 diabetes without hypertension, n = 18; 2 group - patients with diabetes and stage 1 hypertension, n = 19; 3 group - patients with diabetes and stage 2 hypertension, n = 52; 4 group - patients with diabetes and stage 3 hypertension, n = 29; 5 group - patients with stage 1 hypertension, n = 21; 6 group - patients with stage 2 hypertension, n = 46; 7 group - patients with stage 3 hypertension, n = 18. The control group included people without type 2 diabetes and hypertension and amounted 28 people. Glomerular filtration rate (GFR) was calculated by means of CKD-EPI formula. Urinary albumin / creatinine ratio, cystatin C, kidney damage molecule 1 (KIM-1) were used as markers of renal damage. All patients underwent ultrasound abdominal cavity and kidneys examination and echocardiography. Results. Hypertension has the greatest impact on the progression of CKD when combined with diabetes. GFR positively correlates with the indicator of heart diastolic dysfunction - E / A peak and negatively with the body mass index and the size of the left atrium according to echocardiography. Marker of tubules KIM-1 lesion in all groups is within normal limits. In all groups, diastolic dysfunction of the left ventricle and hypertrophy of the walls of the left ventricle is expressed, with the ejection fraction preserved. Conclusion. Chronic heart failure is present in 71 % of patients and in 27 % of patients it is combined with chronic kidney disease. In patients with cardiorenal syndrome, filtration function of kidneys is significantly lower, estimated both by concentration of serum creatinine and cystatin C, the percentage of cardiovascular complications is higher, signs of left ventricular hypertrophy and diastolic heart dysfunction are more pronounced.