THE IMPORTANCE OF ENDOTHELIAL GLYCOCALYX AND ITS MARKERS IN EARLY DIAGNOSIS OF RENAL DYSFUNCTION IN CHRONIC HEART FAILURE

Chronic heart failure (CHF) is a multifactorial clinical syndrome characterized by high morbidity and mortality, frequently accompanied by renal impairment that progresses to cardiorenal syndrome. Recent studies have demonstrated that endothelial glycocalyx (EG) dysfunction plays a pivotal role in worsening renal function in CHF. Elevated serum concentrations of EG biomarkers — such as syndecan-1, heparan sulfate, and hyaluronic acid—are strongly associated with microalbuminuria, systolic dysfunction, and reduced glomerular filtration rate. Since conventional markers of renal dysfunction, including creatinine and cystatin-C, typically change only at advanced stages, the detection of EG-related factors alongside them may enable earlier identification of renal reserve decline and interstitial fibrosis. This, in turn, could support timely therapeutic interventions and improve outcomes in patients with CHF.