Cystatin C Is Diagnostic and Prognostic Factor of the Development of Cardiorenal Syndrome in Comorbid Patients With Arterial Hypertension

Objective: The purpose of the study was to determine the diagnostic and prognostic role of cystatin C in the development of cardiorenal syndrome in the case of arterial hypertension syndrome and maximum comorbid conditions. Design and method: 111 patients with AH (men/women – 50/61) and 20 control subjects were examined. All patients with AH at the age of 54.37±1.18 During a thorough examination and follow-up of patients, they were classified into 4 groups depending on the comorbidities they had: patients with AH – group 1 – 22 persons; patients with AH in combination with obesity – group 2 – 30 persons; AH in combination with type 2 diabetes – group 3 – 31 persons; patients with AH, type 2 diabetes and obesity – group 4 – 28 persons. Results: According to the study, the Cys C level in the examined patients with AH and various comorbidities was significantly higher compared with the control group, with p < 0.0001. We found that cardiotrophin-1, a versatile biomarker for the development and progression of cardiovascular disorders in patients with AH and various comorbidities, has a significant impact on this index (ρ=0.015). The first place among the properties of cardiotrophin-1 in the body is its role in the regulation of heart remodeling in patients with hypertension, heart failure, coronary heart disease in combination with T2DM and hypertension. The resulting relationship between cardiotrophin-1 and Cys C can testify to the latter's contribution to the development of cardiovascular complications in patients with AH, T2DM, and obesity. Conclusions: Serum cystatin C level is a reliable marker of glomerular filtration rate with high diagnostic accuracy, which improves risk stratification for the development of chronic kidney disease in comorbid patients with AH. Elevated cystatin C level may be associated with increased blood pressure, cardiotrophin-1 level, and serum catestatin value, which indicates its importance for the early development of cardiovascular complications in patients with AH and various comorbidities and proves the significance of adipose tissue hormonal activity for the development of glomerular and tubular dysfunctions.