DEVELOPMENT OF DIAGNOSTIC APPROACHES AND IMPROVEMENT OF PREVENTION OF NEPHROCARDIAL SYNDROME IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

This thesis is devoted to the development of diagnostic approaches and improvement of prevention of nephrocardial syndrome in patients with type 2 diabetes mellitus. Type 2 diabetes is associated with a high burden of renal and cardiovascular complications, and modern evidence shows that kidney and heart dysfunction in these patients should be considered as interconnected pathological processes rather than separate clinical problems. Early markers of kidney injury, particularly albuminuria and reduced estimated glomerular filtration rate, are closely associated with increased cardiovascular risk and may serve as key indicators for early diagnosis of nephrocardial syndrome. The study is based on analysis of contemporary guidelines and scientific publications devoted to diabetic kidney disease, chronic kidney disease risk management, cardiovascular–kidney–metabolic syndrome, and biomarker-based prediction of cardiorenal complications. Particular attention is given to routine diagnostic indicators such as UACR, eGFR, blood pressure, glycemic control, and lipid profile, as well as to additional tools including echocardiography and NT-proBNP. Recent data suggest that NT-proBNP may improve prediction of cardiovascular and renal complications in patients with type 2 diabetes and may therefore strengthen early diagnostic algorithms. The thesis concludes that effective diagnosis and prevention of nephrocardial syndrome require a complex and integrated approach. Early screening, risk stratification, and timely initiation of cardiorenal-protective treatment can reduce progression of kidney disease, lower cardiovascular risk, and improve long-term outcomes in patients with type 2 diabetes.