Early Biomarkers of Cardiorenal Syndrome in Type 2 Diabetes: A Prospective Cohort Study
Department of Internal Medicine and Department of Nephrology, Tertiary Care Teaching Hospital, Kolkata, West Bengal, India
Corresponding Author: Sengupta A, Doctus Journal of Clinical Medicine.
Abstract
Cardiorenal syndrome remains under-recognised in ambulatory type 2 diabetes, where declining filtration and subclinical myocardial strain often progress silently. We followed 412 adults with type 2 diabetes and preserved ejection fraction for 24 months, measuring NT-proBNP, urinary NGAL, cystatin C and albumin-creatinine ratio at six-monthly intervals. Fifty-eight participants (14.1%) met composite cardiorenal endpoints. Baseline urinary NGAL above 132 ng/mL and cystatin C above 1.24 mg/L together predicted the endpoint with a sensitivity of 78% and specificity of 71%, outperforming albuminuria alone. The combination retained significance after adjustment for age, glycaemic control, blood pressure and statin use. Paired biomarker screening at the point of routine diabetic review may identify a high-risk group up to 14 months earlier than current practice.
Keywords
Cardiorenal Syndrome; Type 2 Diabetes; NGAL; Cystatin C; NT-proBNP; Biomarkers
How to Cite
Sengupta A, Mukherjee R, Banerjee P and Roy Chowdhury S. “Early Biomarkers of Cardiorenal Syndrome in Type 2 Diabetes: A Prospective Cohort Study”. Doctus Journal of Clinical Medicine 3.8 (2026): 112-124.
Copyright and Licence
© 2026 Sengupta A. This is an open access article distributed under the Creative Commons Attribution Licence, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.