The Value Of Urinary Microprotein Assay In Diagnosis Of Chronic Cardiorenal Syndrome In Elderly Patients With Heart Failure

Objective:Cardiorenal syndromes were classified into five different type, we discuss one of cardiorenal syndromes in this text that is chronic cardiorenal. To discuss the clinical features of the occurrence of cardiorenal syndrome in patients with chronic heart chronic heart failure and explore the relationship between microalbuminuria and early injury of kidney. In addition, elderly patients with heart failure were grouped by TCM, We analysis the correlation among different TCM syndrome types,cardiac function class,cardiac ultrasound index and microalbuminuria in order to make TCM more objective and standardization.Methods:Retrospective analysis 170 cases of the elderly patients with chronic heart failure who were admitted into guang zhou military hospital. All patients must evavuate constitutional kidney disease, diabetes, hematonosis, connective tissue disease, malignant tumor and cerebrovascular Disease ect. According renal function of patients divided into CRS group and non-CRS group. Using immune nephelometry, the level of urine microalbumin (mALB), transferring (TRF), immunoglobulin G(IgG),αl-microglobulin(a 1-MG) andβ2-microglobulin(β2-MG) were measurd in 170 chronic heart chronic heart failure. We collected the data of the patients's gender, age, history, blood pressure, heart rate et al. recorded the clinic indexes such as blood routine, BNP, liver and renal function, blood fat and hyperacoustic data. We built the database by SPSS13.0 to anlysis the differences of the clinical information between the two groups.Result:The patients of CRS group are older compared with the non-CRS group. Coronary heart disease and hypertension are high disease rate in the causes of chronic heart failure. The CRS group's RBC, Hb, Cr, BUN, Cys C and BNP compared to the non-CRS group, the differences have statistical significance. The data of hyperacoustic such as LVDd, LVDs andIVSd increase and LVEF decrease obviously compared to the non-CRS group. The classify of NYHA have significant diffrences. The level of microalbum in uria gradually increased company with the grade of NYHA raise. The protein of kidney glomerulus(mALB, IgG)) and protein of tubules(β2-MG,α1-MG) have linear correlations. Microalbum in uria combine measurement have high rate compare with single measure. The mortality become increased when eGFR< 60, and especially eGFR< 30 the mortality rasied significance. Two groups have obviously differences between digitalis, diuretic and ACEI in therapy.Conclusions:elderly patients with chonic heart failure might have early renal impairment, but common serum renal function tests have not detected. with grading of cardiac raising, the level of microalbum in uria increase. Microalbum tests help to detect early renal injury. TRF has more susceptive responsed aglomerular impair than mALB and a 1-MG has more susceptive responsed tubules injury thanβ2-MG. Patients with heart failure have both aglomerular and tubules hurt at the same time. Combine measurement can discovery renal impair early. To supply renoprotected treatment appropriate and avoid to use some medicine causing renal impaired.