ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2025-2-52-58ssmu-6051Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSПрогностическое значение острого повреждения почек у пациентов, госпитализированных с острой декомпенсацией хронической сердечной недостаточностиPrognostic value of acute kidney injury in patients hospitalized with acute decompensation of chronic heart failurehttps://orcid.org/0000-0002-5873-1768КобалаваЖ. Д.KobalavaZh. D.

Кобалава Жанна Давидовна – д-р мед. наук, профессор, чл.-корр. РАН, зав. кафедрой внутренних болезней с курсом кардиологии и функциональной диагностики им. акад. В.С. Моисеева

Россия, 117198, г. Москва, ул. Миклухо-Маклая, 8

8 Miklouho-Maclay St., 117198 Moscow, Russian Federation

zkobalava@mail.ruhttps://orcid.org/0009-0004-2428-608XКонтареваН. И.KontarevaN. I.

Контарева Наталья Ильинична – аспирант, кафедра внутренних болезней с курсом кардиологии и функциональной диагностики им. акад. В.С. Моисеева

Россия, 117198, г. Москва, ул. Миклухо-Маклая, 8

8 Miklouho-Maclay St., 117198 Moscow, Russian Federation

https://orcid.org/0000-0001-6847-8797ТолкачеваВ. В.TolkachevaV. V.

Толкачева Вероника Владимировна – д-р мед. наук, профессор кафедры внутренних болезней с курсом кардиологии и функциональной диагностики им. акад. В.С. Моисеева 

Россия, 117198, г. Москва, ул. Миклухо-Маклая, 8

8 Miklouho-Maclay St., 117198 Moscow, Russian Federation

tolkachevav@mail.ruhttps://orcid.org/0000-0002-6697-2393КарапетянЛ. В.KarapetyanL. V.

Карапетян Лала Вазгеновна – канд. мед. наук, доцент кафедры внутренних болезней с курсом кардиологии и функциональной диагностики им. акад. В.С. Моисеева 

Россия, 117198, г. Москва, ул. Миклухо-Маклая, 8

8 Miklouho-Maclay St., 117198 Moscow, Russian Federation

l.karapetyan@bk.ruРоссийский университет дружбы народов (РУДН) им. Патриса ЛумумбыРоссияPeoples’ Friendship University (RUDN University)Russian Federation2025140720252425258Copyright © Кобалава Ж.Д., Контарева Н.И., Толкачева В.В., Карапетян Л.В., 20252025Кобалава Ж.Д., Контарева Н.И., Толкачева В.В., Карапетян Л.В.Kobalava Z.D., Kontareva N.I., Tolkacheva V.V., Karapetyan L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/6051

Цель: изучить влияние острого повреждения почек (ОПП) на прогноз у пациентов, перенесших госпитализацию по поводу острой декомпенсации хронической сердечной недостаточности (ОДХСН), в отношении комбинированных почечных и сердечно-сосудистых исходов в течение 1 года.Материалы и методы. Включены 108 пациентов, госпитализированных по поводу ОДХСН. Мужчины составляли 60%, средний возраст 68 ± 11 лет. Проводилось стандартное физическое обследование по шкале оценки клинического состояния (ШОКС), лабораторные исследования (определялся уровень креатинина сыворотки, скорость клубочковой фильтрации (СКФ) CKD-EPI 2021, натрийуретический пептид (NTproBNP), альбумин/креатининурия) при поступлении, выписке. Диагноз ОПП устанавливался согласно критериям KDIGO (Kidney Disease: Improving Global Outcomes, Болезнь почек: улучшение глобальных результатов). В качестве сердечно-сосудистых исходов оценивали суммарный показатель смертности от всех причин и повторных госпитализаций с ОДХСН. Почечные исходы включали ухудшение функции почек в виде снижения СКФ > 15% от исходного, снижение СКФ < 30 мл/мин/1,73м2. Почечные и сердечно-сосудистые исходы оценивались во время амбулаторных визитов через 3, 6, 12 мес после выписки.Результаты. Частота развития ОПП во время госпитализации у пациентов с ОДХСН составила 14% (n = 15). Группы с наличием и без ОПП были сопоставимы по клинико-демографическим показателям, клиническому состоянию. Пациенты в группе ОПП на момент госпитализации имели более высокий уровень NT-proBNP, более выраженные нарушения функционального состояния почек, которые сохранялись в течение 1 года. В течение периода наблюдения не выявлено различий по клиническим и лабораторным данным. Наличие ОПП в период госпитализации у пациентов с ОДХСН достоверно повышает риск возникновения комбинированных почечных и сердечно-сосудистых исходов в течение 1 года наблюдения (отношение рисков 7,6; 95%-й доверительный интервал: 2–29; р = 0,003).Заключение. Развитие ОПП у пациентов с ОДХСН является предиктором неблагоприятного прогноза в отношении комбинированных почечных и сердечно-сосудистых исходов в течение 1 года.

Aim. To study the effect of acute kidney injury in patients hospitalized with acute decompensation of chronic heart failure (ADCHF) in relation to combined renal and cardiovascular outcomes during 1 year of follow-up.Materials and methods. A total of 108 patients hospitalized with ADCHF (mean age 68.3 ± 10.0 years, 60% men) were included in a single-center prospective study. All patients included in the study underwent a standard physical and laboratory instrumental examination, including an assessment of the clinical condition according to the Rating Scale of Clinical State (RSCS) and laboratory tests (including serum creatinine level, glomerular filtration rate (GFR) using the CKD-EPI 2021 equation, albumin to creatinine ratio in urine, natriuretic peptide (NT-proBNP) upon admission and discharge. Acute kidney injury (AKI) was diagnosed based on the KDIGO guidelines (Kidney Disease: Improving Global Outcomes). The total rate of all-cause mortality and repeated hospitalizations from ADCHF was evaluated as cardiovascular outcomes. Renal outcomes included deterioration of renal function in the form of a decrease in GFR >15% of baseline and a decrease in GFR < 30 ml/min/1.73 m2. Combined renal and cardiovascular outcomes were assessed during outpatient visits 3, 6, 12 months after discharge.Results. The incidence of AKI during hospitalization in patients with ADCHF was 14% (n = 15). The groups with and without AKI were comparable in terms of clinical and demographic parameters and clinical assessment scale parameters. However, patients in the AKI group had higher baseline values of NT-proBNP and more pronounced impaired renal function, which persisted for 6–12 months of follow-up. There were no differences in clinical and laboratory data during the follow-up period. In patients with ADCHF, the presence of AKI during hospitalization significantly increases the risk of combined renal and cardiovascular outcomes during 1 year of follow-up (HR = 7.6; 95%CI = 2–29; p = 0.003).Conclusion. The development of AKI during hospitalization in patients with ADCHF is a predictor of an unfavorable prognosis for combined renal and cardiovascular outcomes during 1 year of follow-up.

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The authors declare that there are no conflicts of interest present.