Acute Cardiorenal Syndrome in Therapeutic Practice: Clinical Variants and Prognosis

Murkamilov I.T., Aitbaev K.A., Fomin V.V., Raimzhanov Z.R., Yusupov F.A., Yusupova T.F., Yusupov A.F., Solizhonov J.I., Khabibullaev K.K.

1) Kyrgyz State Medical Academy named after. I.K. Akhunbaev, Bishkek, Kyrgyzstan; 2) Salymbekov University, Bishkek, Kyrgyzstan; 3) Sechenov University, Moscow, Russia; 4) N.N. Burdenko Main Military Clinical Hospital, Moscow, Russia; 5) Osh State University, Osh, Kyrgyzstan; 6) Kazan State Medical University, Kazan, Russia

Cardiorenal syndrome (CRS) refers to interrelated pathological conditions involving the heart and kidneys, in which acute dysfunction of one organ leads to acute dysfunction of the other. Currently, CRS is classified into acute and chronic CRS, acute and chronic renocardiac syndrome, and secondary CRS. Hemodynamic, vascular, metabolic, neurohormonal, cytokine, and inflammatory mechanisms contribute to the development of CRS. Growing interest in CRS is associated with the rising incidence of chronic heart failure and chronic kidney disease. The diagnosis of acute CRS involves electrocardiography (focal myocardial changes, conduction and excitability disturbances, myocardial hypertrophy), echocardiography (reduced left and/or right ventricular ejection fraction, regional hypokinesia, assessment of intracardiac hemodynamics and valvular structures, pulmonary artery pressure), vascular ultrasound (assessment of central venous congestion, renal and hepatic venous congestion, presence of free fluid), as well as cardiac and renal biomarkers (troponin I, NT-proBNP, creatinine, cystatin C).
Clinical case. This article presents a clinical case of acute CRS in a young patient triggered by a respiratory infection. ECG revealed conduction abnormalities. Holter monitoring showed frequent episodes of second-degree sinoatrial block (Mobitz type I) with escape atrial and ventricular complexes, along with 42 monomorphic ventricular and 12 supraventricular extrasystoles. During treatment, laboratory parameters demonstrated a decline in inflammatory markers (leukocytes, neutrophils, C-reactive protein, fibrinogen, D-dimer, procalcitonin), lactate dehydrogenase, and NT-proBNP, along with improved kidney function (reduction in creatinine and cystatin C, increase in estimated glomerular filtration rate). Blood levels of troponin I and IL-6 remained within normal ranges.

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About the Authors

Ilkhom T. Murkamilov – Dr.Sci. (Med.), Corresponding Member of the Russian Academy of Natural Sciences, Associate Professor at the Department of Faculty Therapy, I.K. Akhunbaev KSMA, Director of the Multidisciplinary Medical Center “Doc University Clinic”, Salymbekov University. Address: 720020 Bishkek, Akhunbaev str., 92;
tel.: (+996) 557-221-983; e-mail: murkamilov.i@mail.ru. ORCID: https://orcid.org/0000-0001-8513-9279.
Kubanych A. Aitbaev – Dr.Sci. (Med.), Professor, Department of Intensive Care Medicine, Therapy and Diagnostics, Salymbekov University. Address: 720040 Bishkek,
Bokonbaev str., 144; tel.: (+996) 555-758-476; e-mail:aitbaev.kuban1940@gmail.com. ORCID: https://orcid.org/0000-0003-4973-039X.
Viktor V. Fomin – Dr.Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Faculty Therapy No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, Vice-Rector for Innovation and Clinical Activities, Sechenov First Moscow State Medical University. Address: 119991 Moscow, Bolshaya
Pirogovskaya str., 2; tel.: +8 (495) 609-14-00, ext. 2142; e-mail: fomin_vic@mail.ru. ORCID:https://orcid.org/0000-0002-2682-4417.
Zafarbek R. Rayimzhanov – is a neurologist at the 29th Neurological Department of the N.N. Burdenko Main Military Clinical Hospital, Address: 105094 Moscow,
Hospital square, 3; tel.: 8 (499) 263-55-55; e-mail: rzrmam@mail.ru. ORCID: 0000-0001-5746-6731.
Furkat A. Yusupov – Dr. Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University.
Address: 723500 Osh, Lenin str., 331; tel.: (+996) 990-999-291; e-mail: furcat_y@mail.ru. ORCID: https://orcid.org/0000-0003-0632-6653.
Tursunoy F. Yusupova – Clinical Resident of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University. Address: 723500 Osh,
Lenin str., 331; tel.: (+996) 707-130-938; e-mail: yusupova_tursunoy_f@mail.ru. ORCID: https://orcid.org/0000-0002-8502-2203.
Abdulhokim F. Yusupov – Assistant of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University. Address: 723500 Osh, Lenin str., 331; tel.: (+996) 999-767-808; e-mail: furcat_y@mail.ru.
Jaloliddin I. Solizhonov – 6th-year student of the Faculty of Medicine, Kazan State Medical University. Address: 420012 Kazan, Butlerova str., 49;
tel.: (+495) 967-4690-0438; e-mail: jaloliddinsolijonov44@gmail.com. ORCID: https://orcid.org/0009-0003-0078-0609.
Komil K. Khabibullaev – 6th-year student of the Faculty of Medicine, I.K. Akhunbaev KSMA. Address: 720020 Bishkek, Akhunbaev str., 92; tel.: (+996) 706-474-201,
e-mail: khabibullaevkomil2001@gmail.com. ORCID: https://orcid.org/0009-0004-5508-8019.

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