CORRELATION OF CARDIOVASCULAR RISK WITH RENAL DYSFUNCTION FACTORS IN STABLE ANGINA Rakhimova M.E. Gadaev A.G.

Аннотация

Ischemic heart disease is one of the main causes of disability and death among the population all over the world, including in Uzbekistan. Among the comorbid conditions observed in this group of patients, kidney dysfunction is of particular importance, and even the earliest subclinical disorder affects the exacerbation of the main disease and the development of complications, as well as mortality rates as an independent risk factor. This article aims to investigate the significance of creatinine, cystatin C, proteinuria and podocyturia in early diagnosis of RD in patients with stable angina pectoris and their association with cardiovascular risk. Cystatin C has been reported to be reliably effective compared to serum creatinine in the early diagnosis of RD in patients with stable angina pectoris. It has also been confirmed that podocyturia is one of the main markers for its early detection and assessment of its progression. Key words: ischemic heart disease, risk factor, dyslipidemia, renal dysfunction, glomerular filtration rate, cystatin S, creatinine, podocyturia. КОРРЕЛЯЦИЯ СЕРДЕЧНО-СОСУДИСТОГО РИСКА С ФАКТОРАМИ НАРУШЕНИЯ ФУНКЦИИ ПОЧЕК ПРИ СТАБИЛЬНОЙ СТЕНОКАРДИИ Аннотация. Ишемическая болезнь сердца является одной из основных причин инвалидизации и смертности населения во всем мире, в том числе и в Узбекистане. Среди сопутствующих заболеваний, наблюдаемых у данной группы больных, особое значение имеет нарушение функции почек, причем даже наиболее раннее субклиническое нарушение влияет на обострение основного заболевания и развитие осложнений, а также на показатели смертности как независимый фактор риска. Целью данной статьи является исследование значения креатинина, цистатина С, протеинурии и подоцитурии в ранней диагностике РЗ у больных стабильной стенокардией и их связи с сердечно- сосудистым риском. Сообщается, что цистатин С достоверно эффективен по сравнению с сывороточным креатинином в ранней диагностике РЗ у больных стабильной 5 67 International scientific journal ISSN: 2181-3906 «MODERN SCIENCE АND RESEARCH» 2025 VOLUME 4 / ISSUE 3 / UIF:8.2 / MODERNSCIENCE.UZ стенокардией. Также подтверждено, что подоцитурия является одним из основных маркеров для ее раннего выявления и оценки ее прогрессирования. Ключевые слова: ишемическая болезнь сердца, фактор риска, дислипидемия, нарушение функции почек, скорость клубочковой фильтрации, цистатин S, креатинин, подоцитурия. Among the comorbid conditions observed in patients with ischemic heart disease (IHD), renal dysfunction (RD) is of particular importance and is included in the group of leading risk factors (RF) aggravating cardiovascular system diseases (CSD). [4,7]. Epidemiological and population studies show that even the earliest subclinical impairment of kidney function affects the development of CKD and its complications and mortality as an independent risk factor. When kidney function impairment (KFI) occurs alongside conventional cardiovascular diseases (CVD), it leads to slow-progressing inflammation, endothelial dysfunction, and activation of the sympathoadrenal system (SAS). This also results in damage to atherosclerotic plaques (erosion, calcification). [4, 5, 7, 10, 13, 16] The activation of the SAS further increases the risk of developing acute coronary syndrome (ACS) and worsens the consequences of KFI. [9, 12] Coronary angiography studies showed a 28% rate of three-vessel coronary artery disease (stenosis exceeding 50%) in patients with normal or slightly impaired kidney function, while this figure rose to 53% in patients with moderate to severe KFI. [7, 10, 14, 16] Pathological processes in the kidneys are traditionally assessed based on serum creatinine levels, estimated glomerular filtration rate (eGFR), and micro- and macroalbuminuria (MAU). MAU development signifies sclerosis of 20- 25% of nephrons, and its progression to proteinuria indicates the loss of 50-70% of glomeruli. [1, 9, 12, 14, 15, 21] Studies have proven that albuminuria levels of 30-300 mg/day, or even 10-30 mg/day, significantly increase the risk of developing ACS and overall mortality. [5, 16, 18, 21] According to research by Kotseva K., Saritas T., Floege J., and Belyalov F.I., the presence of persistent proteinuria in patients with CVD, diabetes mellitus (DM), and hypertension (HT) indicates damage to 70-80% of nephrons and the development of chronic kidney disease (CKD). [2, 3, 4, 16, 22] Recent studies have utilized cystatin C as a biological marker for predicting CKD development in patients with CVD. [5, 13, 14] Cystatin C levels in serum are more stable than creatinine and less affected by factors like age, gender, muscle mass, and dehydration. Its clinical sensitivity and specificity for kidney damage are reported as 86% and 82%, respectively. [6, 15, 18]. 5 68 International scientific journal ISSN: 2181-3906 «MODERN SCIENCE АND RESEARCH» 2025 VOLUME 4 / ISSUE 3 / UIF:8.2 / MODERNSCIENCE.UZ The role of podocytes and podocyte-associated molecules in glomerular f