Reduced Albuminuria and Potassemia Indicate Early Renal Repair Processes after Resynchronization Therapy in Cardiorenal Syndrome Type 2
| Autor: | Marcin Braun, Danuta Mazur, Piotr Szafarz, Tomasz Stepek, Agnieszka Gala-Błądzińska, Andrzej Przybylski, Janusz Romanek, Marcin Chlebuś |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Article Subject Urology Renal function Cardiorenal syndrome 030204 cardiovascular system & hematology Nephrotoxicity Nephropathy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine 0502 economics and business medicine Diseases of the circulatory (Cardiovascular) system Creatinine business.industry 05 social sciences medicine.disease chemistry Heart failure RC666-701 Albuminuria 050211 marketing medicine.symptom Cardiology and Cardiovascular Medicine business Kidney disease Research Article |
| Zdroj: | Cardiology Research and Practice Cardiology Research and Practice, Vol 2020 (2020) |
| ISSN: | 2090-8016 |
| Popis: | Background. Patients with chronic cardiorenal syndrome type 2 (T2-CRS) who qualify for resynchronization therapy (CRT) are exposed perioperatively to potentially nephrotoxic factors including contrast agents and blood loss. Methods. The objective of this prospective interventional study was to assess the effects of CRT on renal function in patients with T2-CRS within the first 48 hours following implantation. Initially, 76 patients (15% female; aged 69 ± 9.56 years) with heart failure (New York Heart Association classes II–IV), ejection fraction ≤ 35%, and QRS > 130 ms were included in the study. During CRT implantation, a nonionic contrast agent (72.2 ± 44.9 mL) was administered. Prior to and 48 hours following implantation, renal function was evaluated using the following serum biomarkers: creatinine (sCr), estimated glomerular filtration rate (using the Chronic Kidney Disease Epidemiology Collaboration equation [eGFRCKD-EPI]), and the electrolyte and urine biomarkers albumin (uAlb), albumin/creatinine ratio (UACR), and neutrophil gelatinase-associated lipocalin (uNGAL). Results. Before CRT, patients classified as NYHA class III or IV had higher uNGAL levels in comparison to uNGAL levels after CRT (43.63 ± 60.02 versus 16.63 ± 18.19; p=0.041). After CRT implantation, uAlb, UACR, and potassium levels were reduced (p<0.05), and uNGAL, sCr, and eGFRCKD-EPI were unchanged. The contrast medium volume did not correlate with the test biomarkers (p>0.05). Conclusions. In patients with T2-CRS, uNGAL is a biomarker of kidney injury that correlates with the NYHA classes. A stable uNGAL value before and after CRT implantation confirms the lack of risk of contrast-induced nephropathy. Reduced albuminuria and blood potassium are biomarkers of improving T2-CRS in the early post-CRT period. |
| Databáze: | OpenAIRE |
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