#6530 WHAT IS IMPORTANT IN PRIMARY CARDIORENAL INTERACTION SYNDROME
Authors: Tasic Danijela , Dimitrijevic Zorica , Radenkovic Sonja , Kocic Gordana 
Published: June 2023

Abstract

Background and Aims
Renal function is important in congestive heart failure syndrome because existing or secondary-induced renal weakness contributes to the worsening and progression of heart failure. Decreased ejection fraction in acute heart failure leads to more acute kidney damage compared to patients with preserved ejection fraction. Also, heart failure with a drop in the ejection fraction of the left ventricle is not a dominant characteristic of patients with cardiorenal syndrome type 2. A significant risk factor in the first type of cardiorenal syndrome is, among others, age and diabetes. The prevalence of heart failure with preserved ejection fraction and increased left ventricular mass is higher in the elderly. The aim of the work is how to differentiate and which factors predispose the occurrence of the first and second types of primary cardiorenal syndrome.

Method
42 subjects, 24 men and 18 women, with an average age of 70.72±9.26 years, with a diagnosis of worsening heart function that led to kidney dysfunction, were analyzed. The first type of cardiorenal syndrome accounted for 57.14% and the second type of cardiorenal syndrome accounted for 42.86%. The study was designed as a cross-sectional comparative study, and the main criterion for the inclusion of subjects was the existence of a new or previously diagnosed clinically manifest cardiovascular disease. Continuous variables are presented with mean values, standard deviations and medians, and categorical variables with frequencies and percentages. The normality of the distribution of continuous variables was determined by the Shapiro-Wilk test. Depending on the normality of the distribution of continuous variables, the comparison of continuous variables between two groups was performed by the student's t-test of unknown samples in the case of normality, or by the Mann-Whitney test in the case that the distribution deviates from normality. Determining the difference in the representation of categorical variable modalities between groups was determined by the chi-squared test. Values of p&lt;0.05 were considered statistically significant.

Results
Based on everything is done, the following was determined as statistically significant:Patients with CRS2 are statistically significantly older than patients with CRS1 (p&lt;0.05, Student's t-test of independent samples), and they also have a statistically significantly higher value of HDL-C (p&lt;0.05).Patients with diabetes (p = 0.0488) and with sinus rhythm (p = 0.0442) were statistically significantly more represented in patients with CRS1.Patients with CRS1 had statistically significantly higher values of serum urea and serum creatinine compared to patients with CRS2 (p&lt;0.05, Mann-Whitney test).In patients with CRS2, the value of AOPP was statistically significantly higher than in patients with CRS1 (p&lt;0.01, Student's t-test of independent samples).

Conclusion
The results obtained in our study are related to the assessment of the functional state of the heart and kidneys in primary cardiorenal syndrome type one and two in which the main predisposing factors are age, diabetes and reduction of renal function. By correlation analysis in the second type of cardiorenal syndrome, HDL-C particles were significantly elevated. Although the values of nitrogen products were lower in the second type of cardiorenal syndrome, AOPP stood out as statistically significant in the lower functional class.