Endocrine Abstracts

Purpose of the Study: To study the relationship between the renal perfusion index and systolic heart function in type 4 cardiorenal syndrome in patients with type 2 diabetes mellitus"

Material and Research Methods: The study, which was performed from January to May 2022, included 48 patients with type 2 diabetes mellitus and stage 1-3 CKD. (16 F, 32 M, age 50±17 years, BMI 27.02±3.44 kg/m²) according to the study protocol. Hypertensive nephropathy (HT-CKD) addressed 12 patients. None of the patients included in the study had heart failure. The control group consisted of 20 patients with DM2 without CHF and without CKD. The study used clinical and biochemical research methods (glycemia, glycated hemoglobin, IRI, C-peptide, ALT, AST, bilirubin, urea, creatinine, PTI, hormonal studies (renin, angiotensin, aldosterone) as well as instrumental methods of examination - ultrasound internal organs, ultrasonography with an assessment of the overall intensity of cortical perfusion of the kidneys and the renal perfusion index (RPI), ECG, Echo-ECG, indicators of the quality of life of patients (questionnaire), as well as statistical methods.

Research Results: Analyzing the data of dopplerography of the heart and kidneys, we present for the first time the effect of systolic heart function on RI in patients with type 2 diabetes with CKD. This allows with the probability of early non-invasive detection of cardiac systolic pathology during ultrasound of the kidneys, when high-quality ultrasound examination of the structures of the heart is impossible (lack of technique, emphysema, obesity). Finally, it is likely that RI assessment may be useful for early detection of CRS associated with reduced cardiac output [14]. However, the applicability of RI for diagnosing early anomalies of the cardio-renal axis requires further study.

Conclusions: 1) In the group of patients with DM 2 and CKD stages 1-3 without CHF, we detected Echo-ECG changes according to the type of LV diastolic dysfunction of 1-2 degrees with a tendency to increase the mean pressure in the pulmonary artery. 2) RI can be used as an independent marker for predicting the outcomes of CKD in type 2 DM.