CARDIORENAL SYNDROME: CLINICAL CHALLENGES AND MANAGEMENT IN PATIENTS WITH CHRONIC HEART FAILURE

This scientific article analyzes the mechanisms of development, clinical manifestations, and major therapeutic challenges of cardiorenal syndrome (CRS) in patients with chronic heart failure (CHF). Cardiorenal syndrome is characterized by a bidirectional pathophysiological interaction between cardiac and renal dysfunction and significantly increases morbidity and mortality in patients with CHF. The article discusses the mechanisms of CRS associated with hemodynamic disturbances, activation of the renin–angiotensin–aldosterone system (RAAS) and the sympathetic nervous system, inflammation, and oxidative stress based on current scientific evidence. In addition, clinical challenges such as diuretic resistance, fluid imbalance, and deterioration of renal function are reviewed. The study analyzes modern diagnostic approaches, biomarkers (creatinine, glomerular filtration rate, NT-proBNP), and comprehensive treatment strategies, including individualized diuretic therapy, RAAS blockers, and the effectiveness of a multidisciplinary approach.