Publication Details
Abstract
Chronic heart failure (CHF) accompanied by renal dysfunction represents one of the most complex and high-risk conditions in clinical practice. The presence of kidney impairment not only worsens the prognosis but also limits the use of life-saving medications, creating a delicate balance between maintaining cardiac stability and protecting renal function. In this study, 129 patients with CHF were observed, including groups with and without renal dysfunction, alongside a healthy control group. The aim was to evaluate the clinical course, treatment tolerance, and biomarker profiles in order to identify early diagnostic criteria and optimise therapeutic strategies. The findings revealed that patients with renal dysfunction consistently exhibited poorer exercise tolerance, higher NYHA functional class, and markedly elevated levels of NGAL, KIM-1, and cystatin C compared to those with preserved kidney function. Conventional therapies such as ACE inhibitors, ARBs, and MRAs remained effective but required frequent adjustments due to hyperkalemia or worsening renal indices. Diuretic modifications were especially common, underscoring the challenges of balancing congestion relief with renal safety. Importantly, the introduction of SGLT2 inhibitors was associated with improvements in functional capacity and reductions in biomarker burden, demonstrating a protective effect that addressed both cardiac and renal pathways. These results suggest that early recognition of renal injury through biomarker monitoring, combined with careful treatment adjustments, can improve management in CHF patients. The study underscores the need for individualised therapeutic strategies that integrate modern pharmacological options with precise monitoring, ultimately preserving both cardiac performance and kidney function.