ASSESSMENT OF THE PROBABILITY OF DEVELOPING CARDIORENAL SYNDROME TYPE 2 DEPENDING ON POTENTIAL BIOMARKERS IN PEDIATRIC PATIENTS
Introduction. The investigation of cardiorenal syndrome holds significant clinical relevance, as both cardiovascular and renal diseases rank among the leading causes of mortality. Current research efforts are focused on identifying reliable biomarkers for the early detection of acute kidney injury (AKI), which may serve as a valuable predictor for improving prognosis and therapeutic strategies in patients with chronic heart failure.
The study aims to identify biomarkers associated with an increased risk of type 2 cardiorenal syndrome in children.
Materials and methods. We performed a retrospective analysis with a case-control design. From the medical records of the Scientific National Cardiac Surgery Center (NNCC), we identified all pediatric patients with CHF due to DCM who had an initial hospitalization in 2022 and a subsequent re-hospitalization in 2023. Based on their diagnosis at re-hospitalization, patients were classified into two groups: the case group (those with confirmed Type 2 CRS, n=18) and the control group (those with CHF but without CRS, n=21). We then extracted and compared laboratory data from both the 2022 (baseline) and 2023 (follow-up) hospitalizations for all participants.
Results. Reduced serum iron levels were observed at baseline and during follow-up in both the control and case groups (9 and 5.9 µmol/L, respectively). Elevated total bilirubin levels were also detected in both groups (0.41 µmol/L in controls and 0.55 µmol/L in cases). Notably, galectin-3 concentrations were elevated in the case group, showing a 13% increase compared to the control group. Markers of renal dysfunction, including the albumin-to-creatinine ratio (ACR) and the blood urea nitrogen-to-creatinine (BUN/Cr) ratio, were comparable between the two groups (ACR: 31 and 32 mg/g; BUN/Cr: 30 and 32, respectively). Statistically significant correlations were identified between kidney function (as measured by ACR) and levels of serum iron (p=0.05), hemoglobin (p=0.02), and galectin-3 (p=0.02). Galectin-3 was a significant predictor of renal dysfunction, with an 81% increase in the likelihood of renal dysfunction (OR = 1.81, 95% CI). Similarly, the BUN/Cr ratio was associated with a 70% increase in the likelihood of renal impairment (OR = 1.70, 95% CI).
Conclusion. The findings indicate that, despite similar baseline values of key renal markers across groups, galectin-3 levels were significantly elevated in cases and were strongly associated with renal dysfunction. Reduced serum iron and elevated bilirubin levels were observed in both groups, suggesting potential systemic involvement. However, the small sample size limits the statistical power and generalizability of these findings, warranting validation in larger, prospective cohorts.
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Baygalkanova A.I., Abdrakhmanova S.T., Messova A.M., Besbayeva G.K., Tuleubaeva A.A. Assessment of the probability of developing cardiorenal syndrome type 2 depending on potential biomarkers // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol. 27 (6), pp. 21-29. doi 10.34689/SH.2025.27.6.003Похожие публикации:
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