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Patients with type 2 diabetes mellitus (DM) have a high risk of secondary cardiorenal syndrome, which increases the death rate in these patients. Diabetes-associated heart and kidney damage is an important and largely underestimated cause of global morbidity and mortality. The research for new combinations of cardionephroprotective drugs is currently an urgent task. The aim of this study was to evaluate the effectiveness of the combination of valsartan and amlodipine versus the combination of sacubitril/valsartan and amlodipine in relation to cardiac and nephroprotection in patients with type 2 diabetes mellitus. The study involved 96 patients with type 2 diabetes with secondary cardiorenal syndrome. There were 54 (56.25%) men and 42 (43.75%) women. The average age was 60.27±7.53 years. During the study, patients were randomized into two groups. Group 1 (n=48) consisted of patients with type 2 diabetes with age 59.38±7.74 years who received a combination of valsartan and amlodipine for 6 months. Group 2 (n=48) consisted of patients with type 2 diabetes with age 61.17±7.29 years who received therapy which consisted of sacubitrile/valsartan and amlodipine for the same time. The control group consisted of 40 practically healthy volunteers whose average age was 60.3 ± 7.0 years. It was revealed that cardiac markers NT-proBNP, cystatin C, aldosterone are integral indicators of the risk of developing cardiovascular and renal dysfunctions, and increases in patients with type 2 diabetes indicates a high probability of progression of secondary cardiorenal syndrome. A six-month therapy with a combination of antihypertensive drugs valsartan with amlodipine and sacubitrile/valsartan with amlodipine in patients with type 2 diabetes equally effectively reduces blood pressure, while NT-proBNP and cystatin C significantly decrease against the background of an increase in glomerular filtration rate. In patients with secondary cardiorenal syndrome who received a combination of sacubitril/valsartan and amlodipine there was a more pronounced dynamics of a decrease in albuminuria and aldosterone levels.

Secondary cardiorenal syndrome (CRS) in patients with type 2 diabetes is a combined cardiac and renal pathology with a combined and complex not fully understood pathogenesis, quickly leads to the death of the underlying disease. In this case, a violation of the function of one organ affects the functional state of another, and vice versa. An important role in the CRS pathogenesis is played renin-angiotensin-aldosterone system activation, leading to the progression of cardiac and renal hemodynamic disorders. The aim was to study the parameters of intrarenal hemodynamics and their relationship with the level of aldosterone and natriuretic peptide in patients with secondary cardiorenal syndrome in type 2 diabetes mellitus. In the course of the study, 48 patients with type 2 diabetes and secondary CRS were examined. There were 24 men and 24 women. The average age of the examined patients was 60.3 ± 7.5 years. The duration of type 2 diabetes in patients was 9.53±2.82 years. The control group consisted of 40 practically healthy volunteers matched by sex and age. The formation of secondary CRS in type 2 diabetes is accompanied by an increase concentrations of the N-terminal cerebral natriuretic propeptide (p