Effect of COVID-19 on kidney function in patients with arterial hypertension grade 1-2 and CKD

Ivanov, D.D.; Гоженко, А. І.; Ivanova, Mariia; Zavalna, I.М.

doi:10.36485/1561-6274-2022-26-1-34-43

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…12, No. 1,2023 Матеріали конференції / Proceedings of the Conference 2. Rydén A., Nolan S., Maher J., Meyers O., Kündig A., Bjursell M. Understanding the patient experience of chronic kidney disease stages 2-3b: a qualitative interview study with Kidney Disease Quality of Life (KDQOL-36) debrief.…”

Section: список літературиmentioning

confidence: 99%

“…Вступ. Інфікування SARS-CoV-2 пацієнтів із хронічною хворобою нирок (ХХН) і артеріальною гіпертензією 1-2-го ступеня погіршує стан серцево-судинної системи і може сприяти реалізації негативних серцево-судинних подій і несприятливих ниркових ризиків [1]. Наявність хронічної хвороби нирок у поєднанні з артеріальною гіпертензією 1-2-го ступеня та її медикаментозна корекція інгібіторами ренін-ангіотензин-альдостеронової системи (РААС) має значний вплив на стан здоров'я пацієнтів, які інфіковані SARS-CoV-2 [2].…”

Section: неочікувані ефекти вітаміну D при інфекції сечових шляхівunclassified

“…Вагітність при хронічній хворобі нирок (ХХН) викликає занепокоєння серед медичної спільноти, бо може загрожувати проблемами -наявний високий ризик ускладнень вагітності з боку матері та плода, таких як гіпертензивні ускладнення вагітності, передчасні пологи й низька вага дитини при народженні, а також у зв'язку з необхідністю прийому кількох ліків і побоюваннями щодо їх несприятливого впливу на немовлят. Грудне вигодовування (ГВ) біологічною матір'ю корисне для немовлят, особливо коли вони недоношені або перебувають під загрозою, оскільки материнське молоко утворюється спеціально під потреби кожної дитини [1]. Воно змінює свій склад на різних стадіях лактації та сприяє оптимальному зростанню дитини, включно з встановленням циркадних ритмів, отриманням захисних антитіл та формуванням здорового мікробіому кишечника, а також запобігає життєзагрозливим станам у передчасно народжених малюків.…”

Section: грудне вигодовування у жінок з різними стадіями хронічної хв...unclassified

“…Транспорт лікарських засобів у грудне молоко (ГМ) відбувається шляхом дифузії через гематомолочний бар'єр, молекули різного розміру транспортуються за допомогою різних механізмів. Можна з упевненістю припустити, що більшість ліків у певній кількості міститься в ГМ; проте цього впливу зазвичай недостатньо, щоб виправдати припинення ГВ [1]. Існують висоякісні ресурси для перевірки використання ліків під час лактації, про які повинні знати і які повинні використовувати медичні працівники різних спеціальностей, щоб давати жінці, яка годує, доказову інформацію щодо безпечності ліків при ГВ і надавати альтернативу за потреби [2].…”

Section: грудне вигодовування у жінок з різними стадіями хронічної хв...unclassified

“…Американська академія педіатрії (AAP) рекомендує використовувати виключно ГВ протягом приблизно перших 6 місяців, а потім продовжувати ГВ разом з відповідним прикормом, введеним приблизно у 6 місяців, за обопільним бажанням матері й дитини протягом 2 років або більше. Незважаючи на ці рекомендації, звіт, складений центром з контролю й профілактики захворювань США (CDC), свідчить, що небагато жінок із ХХН або після трансплантації нирки годують своїх дітей груддю [1]. Загальноприйнятою рекомендацією є консультування пацієнток на ранніх стадіях ХХН і перед…”

Section: грудне вигодовування у жінок з різними стадіями хронічної хв...unclassified

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Abstracts of the scientific and practical conference with international participation “Current issues of nephrology, dialysis and transplantation — Kidney day in Ukraine 2023” (March 24–25, 2023, Kyiv, Ukraine)

Authors¹

2023

KIDNEYS

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Section: список літературиmentioning

confidence: 99%

Section: неочікувані ефекти вітаміну D при інфекції сечових шляхівunclassified

Section: грудне вигодовування у жінок з різними стадіями хронічної хв...unclassified

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Abstracts of the scientific and practical conference with international participation “Current issues of nephrology, dialysis and transplantation — Kidney day in Ukraine 2023” (March 24–25, 2023, Kyiv, Ukraine)

Authors¹

2023

KIDNEYS

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Terpenoids and phenolic compounds as biologically active compounds of medicinal plants with diuretic effect

Kurkin,

Pravdivtseva,

Zaitseva

et al. 2024

Farm. farmakol. (Pâtigorsk)

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The aim of the study was to summarize and systematize the literature data, as well as the results of the carried out research in the field of medicinal plants used as diuretics in the Russian Federation and abroad.Materials and methods. During the search for this review article materials, the abstract databases of PubMed, Google Scholar, as well as the ResearchGate and elibrary.ru were used. The search was carried out according to the publications for the period from 2005 to 2023. The keywords were as follows: herbal diuretics, diuretic drugs, kidney diseases, types of medicinal plant raw materials. The data from the authors’ previous scientific research on the analysis of the diuretic properties of certain types of medicinal plant raw materials, as well as individual substances of a phenolic nature isolated from them (simple phenols, flavonoids), were also reviewed.Results. It was determined that the diuretic activity of most of the medicinal plants used, is due to such groups of biologically active compounds as terpenoids (essential oils and saponins), simple phenols, flavonoids and anthracene derivatives related to the secondary metabolites. It has been shown that, despite the fact that many herbal diuretics have concomitant anti-inflammatory, antimicrobial, antiviral, antihistamine and other properties relevant from the point of view of etiology and pathogenesis of the disease, it is reasonable to use them as part of collections of medicinal plants and other combined medicinal herbal preparations, as this is in accordance with the global trend. The types of medicinal plant raw materials that can be a promising source of new diuretic herbal medicines, have been examined in this review.Conclusion. It has been determined that terpenoids and phenolic compounds make the greatest contribution to the manifestation of the diuretic activity of medicinal herbal preparations, among which the greatest structural diversity is noted for flavonoids. It has been established that in the composition of any drug, taking into account the peculiarities of etiology and pathogenesis of the disease, herbal diuretics can be both the main drug and an auxiliary component. The expediency of using medicinal plant raw materials with a diuretic effect as part of collections of medicinal plants and other combined preparations used in the treatment of kidney and urinary tract diseases has been also substantiated.

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Renal function in patients with chronic kidney disease and hypertension degree 1–2 against the background of SARS-CoV-2

Zavalna

2023

KIDNEYS

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Background. SARS-CoV-2 infection in patients with chronic kidney disease (CKD) and hypertension degree 1–2 worsens the state of the cardiovascular system and may contribute to cardiovascular events and adverse renal risks. The presence of CKD in combination with hypertension degree 1–2 and its medical correction with renin-angiotensin-aldosterone system (RAAS) inhibitors causes a significant impact on the health of patients infected with SARS-CoV-2. SARS-CoV-2 uses RAAS, namely the receptor for angiotensin-converting enzyme (ACE) 2, as a tool to enter the cell. To choose further approaches and treatment, this combination of three pathological conditions requires careful analysis and research. Objective: to study the functional state of the kidneys in patients with CKD and hypertension infected with SARS-CoV-2. Materials and methods. The article is a fragment of the BIRCOV (ARB, ACE inhibitors, DRi in COVID-19) trial, which was designed according to the POEM (Patient-Oriented Evidence that Matters). The BIRCOV (two-center, open-label, initiative-randomized, in three parallel arms) prospective study enrolled 120 patients with CKD and hypertension degree 1–2, it lasted for 1 year and was registered at ClinicalTrials.gov (NCT03336203). One hundred and twelve outpatients with degree 1–2 hypertension, 83 with combination with CKD, were selected. At the end of the study, 108 patients remained, their results are presented in the article with subsequent statistical processing. Division into groups occurred depending on the drugs received (ACE inhibitors, angiotensin receptor blockers (ARBs) or direct renin inhibitor (DRIs)). Endpoints were: estimated glomerular filtration rate (eGFR), average blood pressure, albuminuria level. In 24 patients, the urine albumin to creatinine ratio was analyzed at the beginning of SARS-CoV-2, then 2, 4, 12, 24 weeks after the onset of the disease. Mathematical processing and statistical evaluation of the research results was done in the medical statistics package. Results. All patients were divided into 3 groups depending on the drug: 35 (32 %) of them received ARBs, 42 (39 %) ACE inhibitors, 31 (29 %) DRIs. At the manifestation of SARS-CoV-2, a decrease in blood pressure was recorded during the first two weeks, with the subsequent return to baseline on week 12 in the group of people who received ACE inhibitors, the lowest indicator was in the DRI group. The use of ACE inhibitors (risk ratio (RR) 1.648, 95% confidence interval (CI) 0.772–3.519, number needed to treat (NNT) 7.0) and ARBs (RR 13.023, 95% CI 1.815–93.426, NNT 19) in the treatment of hypertension significantly increased the risk of withdrawal compared to DRIs. Patients with CKD had similar dynamics of blood pressure during 24 weeks of observation. In CKD, higher mean blood pressure values were obtained compared to other participants of the BIRCOV trial. A simultaneous decrease in eGFR and systolic blood pressure was documented, it was most pronounced in patients with CKD. The lowest results were in people who took ACE inhibitors for 0–24 weeks: the correlation coefficient was 0.815. A decrease in eGFR correlated with the degree of CKD. There was a decrease in eGFR of less than 60 ml/min during the first 4 weeks from the onset of SARS-CoV-2 in 28 people who took ACE inhibitors versus 22 who used ARBs or DRIs: absolute risk was 0.667 (RR 2.00, 95% CI 1.337–2.92, NNT 3.0). The relative risk of eGFR reduction was 16.6 (95% CI 5.263–52.360, NNT 1.774) for people receiving ACE inhibitors versus all patients with CKD, 2.049 for ARBs (95% CI 0.361–11.22, NNT 1.774) and 1.064 for DRIs versus the entire sample of people with CKD (95% CI 0.116–9.797, NNT 431.6). After 12 weeks of follow-up, eGFR almost returned to baseline in CKD stage 2–3a. An increase in the urine albumin to creatinine ratio (which did not reach the baseline within 24 weeks from the onset of the disease) was recorded in CKD patients with stable renal function during the first 12 weeks from the onset of SARS-CoV-2 (the mean values of eGFR were not statistically different within 2–24 weeks). Males had a higher risk of CKD progression to end-stage renal disease. In people with SARS-CoV-2, on the second week from the onset of the disease, a decrease in eGFR was observed with a reciprocal increase in the level of blood uric acid, which differed significantly from the baseline values. The use of dexamethasone was accompanied by a decrease in eGFR (Р ≤ 0.05) and the preservation of these disorders in people with CKD stage 3b-4 up to 24 weeks of observation (RR 0.686, 95% CI 0.264–1.780, NNT 7.636). Conclusions. The course of SARS-CoV-2 in people with hypertension degree 1–2 was characterized by the development of significant hypotension among those taking ACE inhibitors, and in patients with CKD and hypertension taking ACE inhibitors — by a decrease in GFR, hypotension, an increase in albuminuria and in the urine albumin to creatinine ratio, which was transient in most cases. Albuminuria increased less significantly in patients taking ARBs and was practically unchanged when using DRIs. Patients with CKD stage 4 and hypertension degree 2 had the greatest risks of an unfavorable prognosis. The authors hypothesized about the mechanism of SARS-CoV-2 effect when using ACE inhibitors that was similar to that of ARBs (ARB effect), i.e., in people who took ACE inhibitors, the effect of reducing blood pressure was comparable to that of the dual RAAS blockade with ACE inhibitors and ARBs.

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Effect of COVID-19 on kidney function in patients with arterial hypertension grade 1-2 and CKD

Cited by 7 publications

References 17 publications

Abstracts of the scientific and practical conference with international participation “Current issues of nephrology, dialysis and transplantation — Kidney day in Ukraine 2023” (March 24–25, 2023, Kyiv, Ukraine)

Abstracts of the scientific and practical conference with international participation “Current issues of nephrology, dialysis and transplantation — Kidney day in Ukraine 2023” (March 24–25, 2023, Kyiv, Ukraine)

Terpenoids and phenolic compounds as biologically active compounds of medicinal plants with diuretic effect

Renal function in patients with chronic kidney disease and hypertension degree 1–2 against the background of SARS-CoV-2

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