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

This article 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 current evidence indicates that kidney and heart dysfunction in these patients should be interpreted as interconnected pathological processes rather than separate clinical disorders. The study was carried out as a structured narrative review based on contemporary international guidelines and recent scientific publications devoted to diabetic kidney disease, chronic kidney disease risk management, cardiovascular–kidney–metabolic syndrome, and biomarker-based prediction of cardiorenal complications. The results showed that urine albumin-to-creatinine ratio and estimated glomerular filtration rate remain the core indicators for early identification of nephrocardial risk in patients with type 2 diabetes, while additional assessment of cardiovascular status and biomarkers such as NT-proBNP can improve early risk stratification. The analysis also demonstrated that preventive management should include not only glycemic control, but also cardiorenal-protective interventions, including blood pressure control, RAAS blockade, SGLT2 inhibitors, and other evidence-based strategies in appropriately selected patients. It was concluded that the most effective way to reduce progression of nephrocardial syndrome is the application of an integrated diagnostic-preventive model based on early screening, multidisciplinary evaluation, and timely initiation of protective therapy.