Abstract:
Cardiorenal syndrome is characterized by the coexistence of cardiac and renal dysfunction,
significantly worsening patient prognosis. Early detection of renal impairment remains challenging, as creatinine-based
estimation of glomerular filtration rate (GFR) lacks sensitivity in early stages. Cystatin C has emerged as a promising
biomarker for more accurate assessment of kidney function. Methods: This cross-sectional study included 115 patients with
chronic heart failure (New York Heart Association [NYHA] class II–III) complicated by early-stage cardiorenal syndrome.
Patients were divided into NYHA II (n=30) and NYHA III (n=85) groups. Serum creatinine and cystatin C levels were
measured, and GFR was calculated using CKD-EPI equations. Statistical analysis was performed using Student’s t-test, with
p<0.05 considered significant. Results: In NYHA II patients, creatinine-based GFR was 88.4±1.57 ml/min/1.73 m², while
cystatin C-based GFR was significantly lower at 61.3±3.6 ml/min/1.73 m² (p<0.001). In NYHA III patients, the
corresponding values were 79.3±1.67 and 53.5±1.06 ml/min/1.73 m², respectively (p<0.001). Cystatin C-based GFR was
consistently lower than creatinine-based estimates in both groups, indicating earlier detection of renal dysfunction.
Additionally, GFR values decreased with increasing NYHA functional class. Conclusion: Cystatin C-based estimation of
GFR provides a more sensitive assessment of early renal dysfunction in patients with cardiorenal syndrome compared to
creatinine-based methods. Its use may improve early diagnosis and clinical management of these patients.
