CLINICAL AND PROGNOSTIC SIGNIFICANCE OF HYPERURICEMIA, RENAL DYSFUNCTION AND CARDIORENAL RISK IN PATIENTS WITH CHRONIC HEART FAILURE

Chronic heart failure is one of the most important problems in modern cardiology and internal medicine. Its clinical course is often complicated by renal dysfunction, metabolic disorders and cardiorenal syndrome. In recent years, hyperuricemia has been considered not only as a metabolic abnormality, but also as an important marker of disease severity and unfavorable prognosis in patients with chronic heart failure. Elevated serum uric acid is associated with oxidative stress, endothelial dysfunction, inflammation, reduced renal perfusion and neurohormonal activation, all of which may contribute to the progression of heart failure. The aim of this study was to evaluate the clinical and prognostic significance of hyperuricemia, renal dysfunction and cardiorenal risk in patients with chronic heart failure. The study included 124 patients with chronic heart failure of functional classes II–IV. All patients underwent clinical examination, laboratory assessment of serum uric acid, creatinine, urea, electrolytes, lipid profile, C-reactive protein, estimated glomerular filtration rate, electrocardiography and echocardiography. The results showed that patients with hyperuricemia had more severe heart failure, lower estimated glomerular filtration rate, higher creatinine levels, lower left ventricular ejection fraction, more frequent hospitalizations and higher cardiorenal risk. These findings indicate that serum uric acid may be used as an additional prognostic marker in risk stratification of patients with chronic heart failure.