The current diagnosis and clinical prognostic value of kidney dysfunction in patients with coronary heart disease


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Abstract

The problem of kidney dysfunction and its impact on outcomes in different groups of cardiac patients continue to being widely used. Kidney dysfunction is associated with a number of traditional cardiovascular risk factors. The use of new biomarkers, cystatin C in particular, to identify kidney injury can contribute to the improvement of early prediction of a risk for renal failure (RF). Cystatin C satisfies many characteristics as an ideal biomarker that can assist in not only detecting the early forms of kidney injury, but also in assessing the risk of RF, the needs for renal replacement therapy, and the risk of death in intensive care unit patients in cardiac clinics. Kidney involvement in many diseases, including those that are not initially regarded as renal, necessitates the elaboration of uniform approaches to managing patients with identified chronic RF, especially to the early prevention and treatment of its complications, such as anemia, phosphorus-calcium metabolic disorders, which substantially worsen the prognosis of other diseases.

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Современная диагностика и клинико-прогностическое значение дисфункции почек у больных ишемической болезнью сердца. - Аннотация. Проблема дисфункции почек и ее влияние на исходы у различных групп кардиологических пациентов продолжает широко обсуждаться. Дисфункция почек ассоциирована с рядом традиционных факторов риска развития сердечно-сосудистых осложнений. Использование "новых" биомаркеров, в частности цистатина С, для выявления повреждения почек может способствовать усовершенствованию раннего прогнозирования риска почечной недостаточности (ПН). Цистатин С удовлетворяет многим характеристикам "идеального" биомаркера, при помощи которого можно не только выявлять ранние формы повреждения почек, но и оценивать риск развития ПН, потребности в терапии, замещающей функцию почек, и риск смерти у пациентов отделений интенсивной терапии кардиологических клиник. Вовлечение почек при многих заболеваниях, в том числе исходно не считающихся почечными, делает необходимой разработку единых подходов к ведению пациентов с выявленной хронической ПН, особенно в плане раннего предупреждения и лечения ее осложнений: анемии, нарушений фосфорно-кальциевого обмена, существенно ухудшающих прогноз других заболеваний.
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