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42 -10 (84) 2025 - U.I. Nizomov, N.F. Tashkenbaeva - SPECIFICITY OF RENOCARDIAL SYNDROME MARKERS IN KIDNEY DONORS: A CARDIOLOGIST'S VIEW

SPECIFICITY OF RENOCARDIAL SYNDROME MARKERS IN KIDNEY DONORS: A CARDIOLOGIST'S VIEW

U.I. Nizomov - Republican Specialized Scientific and Practical Medical Center of Cardiology

N.F. Tashkenbaeva - Republican Specialized Scientific and Practical Medical Center of Cardiology

D.R. Tairova - Republican Specialized Scientific and Practical Medical Center of Cardiology

Resume

The cardio-renal syndrome (CRS) in kidney donors increases the risk of cardiovascular diseases (CVD), such as left ventricular hypertrophy (LVH) and heart failure, due to compensatory hyperfiltration and activation of the renin-angiotensin-aldosterone system (RAAS) post-nephrectomy. This article analyzes the specificity of CRS biomarkers for early detection of CVD risk in kidney donors, including cardiac-specific (NT-proBNP, hs-CRP) and renal (NGAL, KIM-1, cystatin C) markers. NT-proBNP and hs-CRP exhibit high sensitivity (85–90%) and prognostic value (AUC 0.90–0.95) for diagnosing LVH and atherosclerosis, while NGAL and KIM-1 identify subclinical tubular damage. Cystatin C outperforms creatinine in assessing glomerular filtration rate. Cardio-centric screening strategies (echocardiography, biomarker monitoring every 6–12 months) and prevention, including RAAS inhibitors, statins, SGLT2 inhibitors, and non-pharmacological measures (DASH diet, aerobic exercise), reduce CVD risk by 20–25%. Emerging biomarkers (microRNAs, galectin-3) and genetic screening (APOL1) may enhance diagnostic specificity to 95%. The absence of randomized controlled trials (RCTs) with NT-proBNP as a primary endpoint highlights the need for further research to validate thresholds and optimize care. Integration of ESC/ACC guidelines and transplant protocols ensures long-term donor safety and reduces CVD mortality.

Keywords: cardio-renal syndrome, kidney donors, NT-proBNP, hs-CRP, NGAL, KIM-1, cystatin C, LVH, cardio-centric prevention.

First page

226

Last page

232

For citation:U.I. Nizomov, N.F. Tashkenbaeva, D.R. Tairova - SPECIFICITY OF RENOCARDIAL SYNDROME MARKERS IN KIDNEY DONORS: A CARDIOLOGIST'S VIEW//New Day in Medicine 10(84)2025 226-232 https://newdayworldmedicine.com/en/new_day_medicine/10-84-2025

List of References

  1. Bongartz LG, Cramer MJ, Doevendans PA, Joles JA, Braam B. The severe cardiorenal syndrome: ‘Guyton revisited’. Eur Heart J. 2005 Jan;26(1):11-7. doi: 10.1093/eurheartj/ehi020. Epub 2004 Nov 30. PMID: 15615794.
  2. Ronco C, McCullough P, Anker SD, Anand I, Aspromonte N, Bagshaw SM, Bellomo R, Berl T, Bobek I, Cruz DN, Daliento L, Davenport A, Haapio M, Hillege H, House AA, Katz N, Maisel A, Mankad S, Zanco P, Mebazaa A, Palazzuoli A, Ronco F, Shaw A, Sheinfeld G, Soni S, Vescovo G, Zamperetti N, Ponikowski P; Acute Dialysis Quality Initiative (ADQI) consensus group. Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J. 2010 Mar;31(6):703-11. doi: 10.1093/eurheartj/ehp507. Epub 2009 Dec 25. PMID: 20037146; PMCID: PMC2838681.
  3. Frohlich ED, Tarazi RC, Dustan HP. Hyperdynamic beta-adrenergic circulatory state. Increased beta-receptor responsiveness. Arch Intern Med. 1969 Jan;123(1):1-7. PMID: 5761734.
  4. Laragh JH, Brenner BM. Hypertension: Pathophysiology, Diagnosis, and Management. New York: Raven Press; 1990.
  5. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G; National Kidney Foundation. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003 Jul 15;139(2):137-47. doi: 10.7326/0003-4819-139-2-200307150-00013. Erratum in: Ann Intern Med. 2003 Oct 7;139(7):605. PMID: 12859163.
  6. Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, Omland T, Storrow AB, Abraham WT, Wu AH, Clopton P, Steg PG, Westheim A, Knudsen CW, Perez A, Kazanegra R, Herrmann HC, McCullough PA; Breathing Not Properly Multinational Study Investigators. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002 Jul 18;347(3):161-7. doi: 10.1056/NEJMoa020233. PMID: 12124404.
  7. Mishra J, Ma Q, Prada A, Mitsnefes M, Zahedi K, Yang J, Barasch J, Devarajan P. Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury. J Am Soc Nephrol. 2003 Oct;14(10):2534-43. doi: 10.1097/01.asn.0000088027.54400.c6. PMID: 14514731.
  8. Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis. 2002 Aug;40(2):221-6. doi: 10.1053/ajkd.2002.34487. PMID: 12148093.
  9. Ibrahim HN, Foley R, Tan L, Rogers T, Bailey RF, Guo H, Gross CR, Matas AJ. Long-term consequences of kidney donation. N Engl J Med. 2009 Jan 29;360(5):459-69. doi: 10.1056/NEJMoa0804883. PMID: 19179315; PMCID: PMC3559132.
  10. Neale J, Smith AC. Cardiovascular risk factors following renal transplant. World J Transplant. 2015 Dec 24;5(4):183-95. doi: 10.5500/wjt.v5.i4.183. PMID: 26722646; PMCID: PMC4689929.
  11. Reese PP, Bloom RD, Feldman HI, Rosenbaum P, Wang W, Saynisch P, Tarsi NM, Mukherjee N, Garg AX, Mussell A, Shults J, Even-Shoshan O, Townsend RR, Silber JH. Mortality and cardiovascular disease among older live kidney donors. Am J Transplant. 2014 Aug;14(8):1853-61. doi: 10.1111/ajt.12822. Epub 2014 Jul 9. PMID: 25039276; PMCID: PMC4105987.
  12. House AA, Anand I, Bellomo R, Cruz D, Bobek I, Anker SD, Aspromonte N, Bagshaw S, Berl T, Daliento L, Davenport A, Haapio M, Hillege H, McCullough P, Katz N, Maisel A, Mankad S, Zanco P, Mebazaa A, Palazzuoli A, Ronco F, Shaw A, Sheinfeld G, Soni S, Vescovo G, Zamperetti N, Ponikowski P, Ronco C; Acute Dialysis Quality Initiative Consensus Group. Definition and classification of Cardio-Renal Syndromes: workgroup statements from the 7th ADQI Consensus Conference. Nephrol Dial Transplant. 2010 May;25(5):1416-20. doi: 10.1093/ndt/gfq136. Epub 2010 Mar 12. PMID: 20228069.
  13. Volpe M, Savoia C, De Paolis P, Ostrowska B, Tarasi D, Rubattu S. The renin-angiotensin system as a risk factor and therapeutic target for cardiovascular and renal disease. J Am Soc Nephrol. 2002 Nov;13 Suppl 3:S173-8. doi: 10.1097/01.asn.0000032549.36050.78. PMID: 12466309.
  14. Böger RH. Asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase, explains the “L-arginine paradox” and acts as a novel cardiovascular risk factor. J Nutr. 2004 Oct;134(10 Suppl):2842S-2847S; discussion 2853S. doi: 10.1093/jn/134.10.2842S. PMID: 15465797.
  15. Damman K, Van Veldhuisen DJ, Navis G, Vaidya VS, Smilde TD, Westenbrink BD, Bonventre JV, Voors AA, Hillege HL. Tubular damage in chronic systolic heart failure is associated with reduced survival independent of glomerular filtration rate. Heart. 2010 Aug;96(16):1297-302. doi: 10.1136/hrt.2010.194878. PMID: 20659949; PMCID: PMC3480323.
  16. Doshi MD, Ortigosa-Goggins M, Garg AX, Li L, Poggio ED, Winkler CA, Kopp JB. APOL1 Genotype and Renal Function of Black Living Donors. J Am Soc Nephrol. 2018 Apr;29(4):1309-1316. doi: 10.1681/ASN.2017060658. Epub 2018 Jan 16. PMID: 29339549; PMCID: PMC5875947.
  17. Palazzuoli A, Antonelli G, Quatrini I, Nuti R. Natriuretic peptides in heart failure: where we are, where we are going. Intern Emerg Med. 2011 Feb;6(1):63-8. doi: 10.1007/s11739-010-0438-x. Epub 2010 Sep 18. PMID: 20853071.
  18. Bui AL, Katz R, Kestenbaum B, de Boer IH, Fried LF, Polak JF, Wasserman BA, Sarnak MJ, Siscovick D, Shlipak MG. Cystatin C and carotid intima-media thickness in asymptomatic adults: the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Kidney Dis. 2009 Mar;53(3):389-98. doi: 10.1053/j.ajkd.2008.06.025. Epub 2008 Sep 27. PMID: 18823684; PMCID: PMC3046734.
  19. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024 Apr;105(4S):S117-S314. doi: 10.1016/j.kint.2023.10.018. PMID: 38490803.
  20. Chen J, Budoff MJ, Reilly MP, Yang W, Rosas SE, Rahman M, Zhang X, Roy JA, Lustigova E, Nessel L, Ford V, Raj D, Porter AC, Soliman EZ, Wright JT Jr, Wolf M, He J; CRIC Investigators. Coronary Artery Calcification and Risk of Cardiovascular Disease and Death Among Patients With Chronic Kidney Disease. JAMA Cardiol. 2017 Jun 1;2(6):635-643. doi: 10.1001/jamacardio.2017.0363. PMID: 28329057; PMCID: PMC5798875.

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