Abstract:
Background. Cardiorenal syndrome (CRS) includes a spectrum of renal and cardiac
disabilities, where loss of function of one organ contributes to diminished function of the
other. Cardiorenal syndrome is frequently complicated by comorbid anemia leading to
reciprocal and progressive cardiac and renal damage.
Objective(s). Presentation of the clinical case of a man inpatient in Cardiorecovery ward of
the "Saint Trinity" hospital with Anemia in cardiorenal syndrome (CRAS) brought under
control by i/v iron administration.
Materials and methods. A 69-year-old man presents with palpitations, general weakness,
dyspnea, and retrosternal pain on light physical exertion. Anamnestic, clinical, and
laboratory data were obtained from the medical record. The patient was monitored by ECG
and laboratory tests; he was diagnosed with HTN, DM type 2, chronic HF NYHA III st. C
ACC/AHA, CKD st. III KDIGO.
Results. After analyzing the history, it was determined that he was a patient with chronic
CRS type II. Upon admission, an ECG was performed with atrial fibrillation rhythm, and
blood tests were taken: Hb - 76 g/l, urea - 20.97 mmol/l, creatinine - 198.1 mmol/l, eGFR -
31 ml/min/1.73m2, NT-proBNP - 3290.37 pg/ml, elevated Cystatin C. During
hospitalization, Ferinject 500 mg was administered with a gradual increase in Hb: 82 g/l –
day 1, day 2 - 85 g/l and at discharge 95 g/l; reticulocyte storm: reticulocytes 24.8, RET-He
31.0, RBCHe 27.5, IRF 13.7%, LFR 86.3% and urea – 14.09 mmol/l, creatinine – 149.9
mmol/l, Fe – 9.2 qmol/l, Ferritin – 321 ng/ml.
Conclusion(s). Screening of Hb, ferritin, transferrin saturation and serum Fe in elderly
patients with CRS, and CV and metabolic comorbidities in the prevention of anemia, can
contribute to improving symptoms and functional capacity, reducing the number of
hospitalizations and improving quality of life.
