Role of remodeling of small diameter kidney arteries in the prognosis of progression of tubulointerstitial fibrosis in patients with chronic glomerulonephritis

Левицкая, Е. С.; Батюшин, М. М.; Чистяков, В. А.; Разина, А. В.; Дударев, И. В.

doi:10.15829/1728-8800-2019-3-62-68

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…Диагностика ремоделирования артерий почек малого диаметра при ХГН необходима с целью стратификации риска прогрессирования тубулоинтерстициальной структурной перестройки, поскольку нарушение адекватной перфузии, поврежденной аутоиммунным процессом ткани почек, усугубляет течение основного патогенетического процесса, замыкая "порочный круг". В ранее проведенных авторами исследованиях было показано, что ремоделирование артерий почек малого диаметра при ХГН повышает вероятность потенцирования тубулоинтерстициальных изменений [16].…”

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Prediction of small-diameter arterial fibrosis in patients with hypertension and primary chronic glomerulonephritis

Левицкая

Батюшин

Бондаренко

et al. 2020

Cardiovasc Ther Prev

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Aim. To study clinical, laboratory, and morphological risk factors for small-diameter renal arterial fibrosis in patients with hypertension (HTN) and primary chronic glomerulonephritis (CGN).Material and methods. The study included 102 patients with primary CGN. The first group consisted of 62 patients with small-diameter renal arterial fibrosis according to renal biopsy; the second group included 40 patients without vascular fibrosis. All patients signed informed consent.Results. A comparative analysis revealed the most significant differences between groups 1 and 2: mean systolic blood pressure (SBP) — 131,85±17,56 mm Hg and 119,65±22,2 mm Hg, respectively (p=0,0008); mean diastolic blood pressure (DBP) — 84,11±10,7 and 79,63±9,7 mm Hg (p=0,03), respectively; peak SBP — 158,61±23,76 mm Hg and 144,25±23,56 mm Hg (p=0,002), respectively; peak DBP — 95,66±10,33 mm Hg and 90,63±10,74 mm Hg (p=0,02), respectively; HTN stage — 1,85 [1; 3] and 1,38 [1; 3] (p=0,03), respectively; HTN grade — 1,73 [1; 3] and 1,13 [1; 3] (p=0,004), respectively; left ventricular hypertrophy — 15 patients and 2 patients (p=0,006), respectively; blood urea nitrogen — 8,98±7,31 and 6,42±4,02 mmol/L (p=0,03), respectively. Significant morphological differences between first and second groups were as follows: tubulointerstitial fibrosis — 56% and 21% (p<0,001), respectively; tubulointerstitial inflamemation — 44% and 16% (p=0,002), respectively; interstitial fibrosis — 24,9±20,5% and 9,89±19,8% (p=0,001), respectively.Conclusion. The presented analysis emphasizes a significant contribution of hemodynamics in small-diameter renal arterial fibrosis in patients with HTN and CGN. It manifested by a persistent increase of SBP and involvement of target organs. Systemic hemodynamic changes are fundamental in the development of small-diameter renal arterial fibrosis in patients with HTN and primary CGN, while the isolated progression of CGN does not significantly affect the structure of small-diameter renal arteries.

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Section: Discussionunclassified

Prediction of small-diameter arterial fibrosis in patients with hypertension and primary chronic glomerulonephritis

Левицкая

Батюшин

Бондаренко

et al. 2020

Cardiovasc Ther Prev

Self Cite

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Prediction of remodeling of small diameter arteries in the model of experimental glomerulonephritis

Levitskaya

Батюшин

Kasich

et al. 2020

Nefrologiâ (St.-Peterbg.)

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BACKGROUND. Determining the pathogenetic mechanisms of small-caliber renal artery remodeling in chronic glomerulonephritis (GN) is an urgent task of nephrology, the implementation of which will allow establishing new diagnostic and therapeutic approaches to patients management. THE AIM: To evaluate the influence of hemodynamic, tubulointerstitial, and endothe- liotropic risk factors on the probability of remodeling of interlobular arteries in an experimental model of glomerulonephritis. MATERIALS AND METHODS. The experiment included 45 individuals of white mongrel rats, 3 of which were used to prepare an antigen suspension (AS), and 42 rats were divided into 4 groups: 9 individuals in the main groups (with the introduction of only AS, with the introduction of an incomplete Freund adjuvant, with AS and sodium chloride, with AS and perindopril) and 6 ratsin the control group. Glomerulonephritis was formed in the main groups of the experiment. Systolic blood pressure (SAD), the protein level in the urine, and the presence of edematous syndrome were monitored initially, on the 15th, 30th, and 60th day of the experiment. The size of the interlobular artery (MA) was determined by the morphological study, and the expression of VEGF and TGFp in the kidneys. RESULTS. Morphological signs of glomerulonephritis were obtained in all the main groups of the experiment as early as day 15. The greatest increase in SAD, protein in the urine, the presence of edematous syndrome in groups with the introduction of AS and AS with sodium chloride was found. The highest expression of VEGF and TGFp was found in these groups of rats. In the group with AS with perindopril, normotension was formed, the protein level was lower than in rats with AS with or without the use of sodium chloride, and there was no edematous syndrome. The expression of VEGF and TGFp was minimal. Interlobular artery remodeling in established groups of AS an AC with sodium chloride. In the remaining groups of rats, the size of the interlobular arteries was comparable to the control group. CONCLUSION. The leading role of systemic blood pressure in the remodeling of small-diameter kidney arteries in glomerulonephritis has been established. Despite the presence of active glomerulonephritis in rats, the structure of small arteries does not change during the formation of normotension.

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Role of remodeling of small diameter kidney arteries in the prognosis of progression of tubulointerstitial fibrosis in patients with chronic glomerulonephritis

Cited by 2 publications

References 13 publications

Prediction of small-diameter arterial fibrosis in patients with hypertension and primary chronic glomerulonephritis

Prediction of small-diameter arterial fibrosis in patients with hypertension and primary chronic glomerulonephritis

Prediction of remodeling of small diameter arteries in the model of experimental glomerulonephritis

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