Markers of Kidney Injury in Patients with Chronic Heart Failure of Ischemic Genesis: A Modern View on the Problem
This review explores indicators of kidney damage in individuals suffering from chronic heart failure of ischemic origin. Drawing upon contemporary scientific literature, the article highlights the principal etiological, pathogenetic, and pathophysiological factors that contribute to the development of cardiorenal syndrome from a multidisciplinary perspective. It also identifies current predictors for the onset of this complex condition. The discussion delves into hemodynamic, neurohumoral, and inflammatory influences that perpetuate the ”detrimental cycle” of cardiorenal syndrome. Furthermore, the significant role of specific biomarkers in quantifying the extent of kidney injury, predicting the advancement of chronic kidney disease, and managing patients with ischemic heart failure is examined. Special attention is directed towards understanding how compromised cardiac function impacts renal perfusion and filtration, leading to a cascade of detrimental effects on kidney structures and function. The interplay between the sympathetic nervous system, the renin-angiotensin-aldosterone system, and inflammatory cytokines is elucidated as a crucial aspect of this vicious cycle. By understanding these complex interactions and identifying reliable biomarkers, clinicians can aim for earlier diagnosis, more accurate risk stratification, and ultimately, improved therapeutic strategies for patients at the intersection of cardiovascular and renal disease.
Stefano E.A., Schukina E.V., Marushkin N.S., Pivnev B.A., Komarevsky V.V. 2026. Markers of Kidney Injury in Patients with Chronic Heart Failure of Ischemic Genesis: A Modern View on the Problem. Challenges in Modern Medicine, 49(3): 274–286 (in Russian). DOI: 10.52575/2687-0940-2026-49-3-274-286. EDN: KRXFKB
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Chen F., Lyu L., Xing C., Chen Y., Hu S., Wang M., Ai Z. 2025. The Pivotal Role of TGF-β/Smad Pathway in Fibrosis Pathogenesis and Treatment. Front. Oncol. (15): 1649179. https://doi.org/10.3389/fonc.2025.1649179
Edmonston D., Grabner A., Wolf M. 2024. FGF23 and Klotho at the Intersection of Kidney and Cardiovascular Disease. Nat. Rev. Cardiol. 21(1): 11–24. https://doi.org/ 0.1038/s41569-023-00903-0
Faivre A., de Seigneux S. 2024. The Role of Hypoxia in Chronic Kidney Disease: a Nuanced Perspective. Curr Opin Nephrol Hypertens. 33(4): 414–419. https://doi.org/10.1097/MNH.0000000000000989.
Govardi E., Yulianda D., Habib F., Pakpahan C. 2023. Microalbuminuria and Mortality in Individuals with Coronary Heart Disease: A Meta-Analysis of a Prospective Study. Indian Heart J. 75(4): 229–235. https://doi.org/10.1016/j.ihj.2023.05.006
Hu L., Ding M., He W. 2022. Emerging Therapeutic Strategies for Attenuating Tubular EMT and Kidney Fibrosis by Targeting Wnt/β-Catenin Signaling. Front Pharmacol. (12): 830340. https://doi.org/10.3389/fphar.2021.830340
Jiménez-Uribe A.P., Gómez-Sierra T., Aparicio-Trejo O.E., Orozco-Ibarra M., Pedraza-Chaverri J. 2021. Backstage Players of Fibrosis: NOX4, mTOR, HDAC, and S1P; Companions of TGF-β. Cell Signal. (87): 110123. https://doi.org/10.1016/j.cellsig.2021.110123
Kim A.J., Ro H., Kim H., Ko K.P., Chang J.H., Lee H.H., Chung W., Jung J.Y. 2021. Elevated Levels of Soluble ST2 but not Galectin-3 are Associated with Increased Risk of Mortality in Hemodialysis Patients. Kidney Res Clin Pract. 40(1): 109–119. https://doi.org/10.23876/j.krcp.20.133
Li X., Lindholm B. 2022. Cardiovascular Risk Prediction in Chronic Kidney Disease. Amer. J. Nephrol. 53(10): 730–739. https://doi.org/10.1159/000528560
Lima Posada I., Soulié M., Stephan Y., Palacios Ramirez R., Bonnard B., Nicol L., Pitt B., Kolkhof P., Mulder P., Jaisser F. 2024. Nonsteroidal Mineralocorticoid Receptor Antagonist Finerenone Improves Diastolic Dysfunction in Preclinical Nondiabetic Chronic Kidney Disease. J. Amer. Heart Assoc. 13(12): e032971. https://doi.org/10.1161/JAHA.123.032971
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Schunk S.J., Floege J., Fliser D., Speer T. 2021. WNT-β-catenin Signaling – a Versatile Player in Kidney Injury and Repair. Nat. Rev. Nephrol. (17): 172–184. https://doi.org/10.1038/s41581-020-00343-w
Wang B., Ding C., Ding X., Tesch G., Zheng J., Tian P., Li Y., Ricardo S., Shen H.H., Xue W. 2022. WNT1-inducible Signaling Pathway Protein 1 Regulates Kidney Inflammation through the NF-κB Pathway. Clin. Sci. 136(1): 29–44. https://doi.org/10.1042/CS20210663
Wang Y., Zhang Y., Li J., Li C., Zhao R., Shen C., Liu W., Rong J., Wang Z., Ge J., Shi B. 2023. Hypoxia Induces M2 Macrophages to Express VSIG4 and Mediate Cardiac Fibrosis After Myocardial Infarction. Theranostics. 13(7): 2192–2209. https://doi.org/10.7150/thno.78736
Xu X., Zhang B., Wang Y., Shi S., Lv J., Fu Z., Gao X., Li Y., Wu H., Song Q. 2023. Renal Fibrosis in Type 2 Cardiorenal Syndrome: An Update on Mechanisms and Therapeutic Opportunities. Biomed Pharmacother. (164): 114901 https://doi.org/10.1016/j.biopha.2023.114901