Фенотипические характеристики пациентов с хронической сердечной недостаточностью и сохраненной фракцией выброса в сочетании с хронической болезнью почек

Background. Heart failure with preserved ejection fraction (HFpEF) is a complex clinical condition, often associated with chronic kidney disease (CKD). The interplay between these two conditions remains underexplored. This study aims to examine the phenotypic characteristics of patients with HFpEF in conjunction with CKD, with a focus on biomarker alterations and clinical outcomes. Materials and methods. The study enrolled 200 patients diagnosed with both HFpEF (ejection fraction ≥50%) and CKD stages 1-3b. Clinical data were collected, and various biomarkers, including NT-proBNP, cystatin C, and microalbuminuria (MAU), were measured using chemiluminescent immunoassay (COBAS e411, Roche HITACHI), fluorescent immunoassay (Finecare III PLUS analyzer), and turbidimetric testing (Mindray BS-380 analyzer), respectively. GFR was calculated using the CKD-EPI formula. Results. The results indicated a higher prevalence of Type 2 diabetes (T2D) and atrial fibrillation (AF) among patients with CKD stage 3b. Conversely, those with CKD stage 3a exhibited worse control over blood lipid levels. Notably, a decrease in GFR was significantly correlated with elevated levels of creatinine, cystatin C, and MAU. In patients with CKD stages 1-2, even though creatinine levels were normal, cystatin C and MAU levels were higher than the normative range. Conclusion. Among HFpEF patients, CKD stage 2 in combination with obesity was more common, with changes observed in renal biomarkers such as cystatin C and MAU, despite relatively normal GFR values. This highlights the importance of early detection and management of renal impairment in HFpEF patients, emphasizing a need for comprehensive cardiac and renal care.