Abstract. The purpose of the research is to explore patient’s echocardiography parameters with stage 2 arterial hypertension complicated by chronic kidney disease (CKD). Material and methods: the study involved 100 patients with stage 2 essential hypertension (46 men and 54 women with average age of 59.09±13.51 years). The first group included patients with arterial hypertension complicated by CKD (50 people). The control group consisted of patients with hypertension, in whom the course of hypertension was not complicated by CKD (50 people) - the 2nd group. In the first two days of hospitalization, blood pressure was measured, blood creatinine was assessed, GFR was calculated, the presence of microalbuminuria was assessed, the threshold of taste sensitivity to table salt (TSTSS) was determined, and a transthoracic echocardiographic study (Echo-CG) was performed. The data are presented in the form of M±SD with a normal distribution of the trait, Me±IQR with a description of the trait different from the normal distribution and a percentage ratio (%). To assess the statistical relationship between the indicators, Spearman's rank correlation coefficient (r) was calculated. Results. The study showed that in patients with hypertension complicated by CKD, there are higher blood pressure numbers, almost half of them have insufficient antihypertensive therapy. They have higher values of indicators characterizing the degree of LV hypertrophy and lower values of ejection fraction than in patients without CKD. A direct correlation was found between PS consumption and echocardiographic parameters characterizing LV size and its hypertrophy in AH patients with CKD. At the same time, these indicators were significantly higher in patients with high PHCPS compared to those with a low threshold. Conclusion. The data obtained from the results of ECHO-CG allow us to expand our understanding of the pathogenesis of AH, taking into account such complications as CKD, and can be used for timely correction of antihypertensive therapy, which will prevent the process of progression of AH staging, before the appearance of systemic complications of CKD, and, therefore, improve the prognosis of the disease.
Abstract. Nowadays diabetes mellitus is a socially significant non-infectious disease with epidemic growth of prevalence. Over the past four years there has been a 0.17% increase in the number of patients with diabetes in Russian Federation. According to the data for 2021, 3.23% of population suffer from diabetes, 92.5% of those has type 2 diabetes. Chronic course of diabetes is associated with the development of complications from target organs, among them the most common is diabetic nephropathy, which ranks second in frequency of occurrence, which is about 18.4%. Diabetic nephropathy is characterized by a variety of pathomorphological and pathophysiological changes in the renal tissue based on development of glomerulosclerosis. Prolonged functioning of kidneys filtering system in conditions of hyperglycemia leads to the chronic kidney disease development. Occurrence of this complication increases the risk of cardiovascular accidents in patients with diabetic nephropathy. Over time, chronic kidney disease in absence of appropriate treatment leads to development of terminal renal failure, which requires the use of renal replacement therapy. In this connection, prescription of appropriate antidiabetic therapy, competence of primary health care specialists (general practitioners, endocrinologists) in issues of modern appropriate antidiabetic therapy possibilities in chronic kidney disease conditions will allow to stop the process of disease progression and postpone the beginning of renal replacement therapy as much as possible. The article presents a review of modern Russian and foreign medical literature, concerning the aspects of glucose-lowering therapy for type 2 diabetes mellitus in patients with diabetic nephropathy complicated by chronic kidney disease.
Acute tubulointerstitial nephritis (ATIN) is an acute kidney disease that can develop under the influence of various exogenous and endogenous factors and is manifested by inflammatory changes in the tubulointerstitial tissue of the kidneys, often accompanied by the development of acute renal kidney damage (AKI). Approximately 3–19% of all AKI cases are due to ATIN nephrobiopsy data, which indicates a difficult non-invasive diagnosis of this disease. Complaints of patients with ATIN are few and are associated with manifestations of acute renal damage: a decrease in urine volume, an increase in blood pressure (BP). Important in the diagnosis of ATIN is urinary syndrome, manifested by proteinuria less than 1 gram per day, erythrocyturia, leukocyturia, including eosinophiluria. In patients with suspected ATIN, a full physical examination is performed, attention is drawn to the appearance of pain on palpation of the kidneys, blood pressure is measured, diuresis, and the presence of edema are assessed. In laboratory diagnostics, it is necessary to investigate the level of creatinine, blood urea, general urine analysis, with instrumental — ultrasound examination of the kidneys, if indicated, a kidney biopsy is performed. Treatment is aimed at immediate cessation of the effect of the etiological factor, maintenance of waterelectrolyte balance and correction of violations of acidbase balance, blood pressure. In this regard, it is possible to use crystalloid solutions, loop diuretics (furosemide, torasemide), antihypertensive drugs in accordance with the general principles of management of patients with AKI, immunosuppressive therapy for ATIN immune genesis, with ATIN drug genesis — glucocorticoids. In the presence of appropriate indications, renal replacement therapy is performed. The prognosis of the disease often depends on timely diagnosis and appropriate treatment. The paper presents the clinical case of a female patient affected with acute tubulointerstitial nephritis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.