The Structure of the Anemia Syndrome in Patients With Chronic Heart Failure and Chronic Kidney Disease

Abstract

General Background: Chronic heart failure (CHF) and chronic kidney disease (CKD) frequently coexist, exacerbating clinical outcomes and contributing to anemia, which further deteriorates cardiovascular and renal functions. Specific Background: Anemia in CHF and CKD is multifactorial, involving iron deficiency, chronic inflammation, and protein-energy malnutrition. The pathophysiological mechanisms, including erythropoietin resistance and impaired iron metabolism, require further investigation to optimize therapeutic interventions. Knowledge Gap: Despite recognition of anemia's role in CHF and CKD progression, the structural characteristics of anemia syndrome, particularly the interaction between iron metabolism markers and nutritional status, remain insufficiently studied. Aims: This study aims to determine the structure of anemia syndrome in CHF and CKD patients by analyzing iron parameters, transferrin saturation, hemogram indices, and protein metabolism markers to assess their impact on anemia severity. Results: The findings reveal a predominance of anemia of chronic disease (ACD), with progression leading to a combination of ACD and iron deficiency anemia (IDA). Severe anemia was linked to significant reductions in iron stores, transferrin saturation, and markers of protein metabolism, indicating trophological disturbances. Novelty: This study identifies the combined influence of iron metabolism and malnutrition in CHF-CKD patients with anemia, offering a comprehensive perspective on anemia pathogenesis beyond iron deficiency alone. Implications: The results emphasize the necessity of an integrated therapeutic approach that includes anemia correction and nutritional interventions to improve patient outcomes. Further research should explore the relationship between nutritional status, iron metabolism, and CHF decompensation to refine clinical management strategies.