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The purpose of this paper is to analyses the cases with cardiorenal syndrome, and the ratio of cardiovascular disease and COVID-19. Prospective methods were used to conduct this research, including the period (January 2020-December 2021). Cases of patients treated at the Nephrology Clinic at the University Clinical Center of Kosovo (UCCK) have been studied. The categorical variables were analyzed with the X² test and the Fisher exact test. The study included 120 patients with acute renal disease treated at the Nephrology Clinic at the University Clinical Center of Kosovo (UCCK), of which 46 (38.3%) female and 74 (61.6%) male. Of the 120 patients included in the study 4 were 18-34 years old, 8 were 35-49 years old, 30 were 50-64 years old, and 78 were > 65 years old. There is a strong link between cardiorenal syndrome and age. Regarding cardiorenal syndrome and its association with other diseases in this prospective study were found these concomitant diseases such as: diabetes mellitus type 2, secondary anemia, hypothyroidism, hyperparathyroidism, pneumonia, sepsis, ascites, mesenteric tumor, hyperkalemia, and Covid-19 Infection. There is a strong link between cardiorenal syndrome and COVID-19 Infection. In recent decades various studies have been done against the definition of cardiorenal syndrome, the understanding of pathophysiology, the use of new biomarkers that represent a new dimension in the diagnostic algorithm, and the difficulties in treating this syndrome.

Aim - to study the predictors of cardiovascular events in patients with chronic heart failure (CHF) with preserved left ventricular ejection fraction role of traditional and non-traditional risk factors, to analyze the prognostic role of hyponatremia. Analysis of the clinical features of CHF was provided by retrospective research of medical cards in 308 patients, with endpoint verification during long-term period from 2010 to 2015. Among the examined patients 81 addmitted to the intensive care unit. The study showed that in obesity patients with body mass index (BMI) more than 30 kg/m2, the incidence of CHF decompensation was higher (p<0,05), but a significant mortality in CHF is only possible with abdominal obesity. It was proved the significant increase of CHF decompensation at patients with diabetes mellitus (p<0,05), the gender specificity of the disease was the higher risk of cardiovascular mortality in males (p<0,05).It was found that the most often in patients with CHF decompensation was reduced systolic pressure with an absolute risk of 82,7%. It was established a significantly higher risk of cardiovascular mortality in CHF with a sodium level less than 135 mmol/l, an increase from 19,0 to 45,0%, the "cut-off point" was established at the Na+ level between 115.0-125.0 mmol/l. After analyzing of the "combined" risk with hyponatremia and obesity, cardiovascular mortality increased to 23,0%.In the group with severe decompensation of CHF, it was set the lower hemoglobin level (p<0,05), lower hematocrit (p<0,05), higher ESR (p<0,05) and total leukocyte count(p<0,05).Absolute risk of cardiovascular mortality with hemoglobin level before 120 g/l was 48,0% vs. 16,0% of patients with normal hemoglobin level. Significant factors, combined with frequent hospitalization were age over 65 years (p<0,05), body mass index more than 30 kg/m2 (p<0,05), III and IV functional classes of CHF (p<0,05),hemoglobin level less than 120 g/l (p<0,05), hyponatremia (p<0,05).It was set the reliable influence of combined hyponatremia and obesity on the frequency of hospitalizations in CHF patients with an increase of absolute risk with 55,0%, reliable RR and OR (p<0,05).

Chronic kidney disease (CKD) increases the risk of all-cause mortality and cardiovascular disease as well as progression to end stage kidney failure. The relationship of glomerular filtration rate (GFR) and albuminuria with clinical outcomes in the general population are revealed. This allows to present levels of GFR and microalbuminuria (MA), which increases the risk of mortality. Renal dysfunction, which revealed by the level of GFR and creatinine, can have definite role in hemodynamic changes and heart failure progression. For mentioning the interaction of cardiovascular and renal diseases the cardiorenal syndrome (CRS) term was introduced, with its classification on 5 types, according to the presence of acute/chronic heart failure and primary/secondary origination of heart and kidney injury. We study interrelations between echocardiographic data of left ventricular remodeling, MA level and degree of renal dysfunction in 115 patients with CRS. MA was measured with diagnostic strips, contractile function of left ventricle (LV) - by echocardiography and GFR was assessed by Cocroft-Gault method. The association between MA with decreased GFR and elevated creatinine levels and its connection with increased LV myocardial mass and preclinical disturbances of LV systolic function was revealed. We determined direct correlation between MA and myocardial mass index and indirect - between ejection fraction of LV and MA. Obtained data allow to mention the level of MA (25,4±5,8 ng/ml) in which there is more probability of LV contractile functional changes, which will allow early prediction and prevention of CRS progression and pathogenetically approved pharmacotherapy organization in this category patients.