Interlinking Diabetic Cardiomyopathy and Renal Dysfunction: A Multisystemic Perspective

Abstract

Diabetic cardiomyopathy and renal dysfunction are increasingly recognized as interconnected complications of long-standing diabetes, sharing overlapping metabolic, inflammatory, and hemodynamic pathways. This study investigates the multisystemic association between cardiac structural impairment and renal functional decline using an integrated mixed-methods experimental design. Quantitative biochemical profiling, echocardiographic assessment, and renal filtration measurements were combined with qualitative clinical interpretation to construct a unified model of the cardio-renal axis in diabetes. Results demonstrated a consistent relationship between decreasing estimated glomerular filtration rate (eGFR) and worsening global longitudinal strain (GLS), accompanied by elevations in NT-proBNP, inflammatory cytokines, and oxidative stress biomarkers. Cardiac deformation indices and renal dysfunction stages showed parallel progression, supporting the hypothesis that both organs deteriorate through shared mechanisms involving microvascular injury, endothelial dysfunction, and mitochondrial stress. Scatter and trend analyses further revealed clustering patterns of multisystemic risk, indicating that early abnormalities in one organ predict subsequent impairment in the other. The integrated cardio-renal model developed in this study underscores the need for clinical frameworks that evaluate cardiovascular and renal systems jointly rather than independently. These findings highlight the importance of early multisystemic screening and holistic intervention strategies to mitigate progression and improve outcomes in diabetic populations. Overall, the study strengthens the understanding that diabetic cardiomyopathy and renal dysfunction represent a continuous, interconnected disease spectrum driven by metabolic and inflammatory cross-talk rather than separate pathological entities.