Terapevticheskii arkhiv · 2008
[Cardiorenal syndrome in ischemic renal disease (atherosclerotic renovascular hypertension)].
Редакционная статьяАннотация на английскомНазвание и аннотация: Оригинал на русском
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mukhin N A, Fomin V V, Moiseev S V, Shvetsov M Iu, Kutyrina I M, Zaĭtsev A Iu, Taronishvili O I
Аннотация
AIM: To characterize cardiorenal syndrome in ischemic renal disease (IRD).
MATERIAL AND METHODS: In examination of 105 IRD patients (63 males and 42 females, mean age 63.8 +/- 5.1 years) we estimated body mass index (BMI), indices of peripheral blood and urine, blood biochemistry, glomerular filtration rate (GFR). Plasmic homocystein concentration was measured in 30 patients. We also studied incidence of some cardiovascular risk factors, clinical variants of atherosclerosis and their correlation with GFR.
RESULTS: IRD patients most frequently had hypertriglyceridemia (67.6%), hypercholesterinemia (53.3%), smoking (47.1%), obesity (41.9%), metabolic syndrome (38.1%), type 2 diabetes mellitus, arterial hypertension of the third degree (70.6%), isolated systolic arterial hypertension (46.7%). GFR was significantly lower in smokers (p < 0.001), arterial hypertension of the third degree (p < 0.05), isolated systolic arterial hypertension (p < 0.001) and type 2 diabetes mellitus (p < 0.05). In GFR < 40 ml/min homocysteinemia increased significantly (p < 0.01). Coronary artery disease in IRD occurred in 52.4%, cerebrovascular diseases (brain stroke, transitory ischemic attacks)--in 29.5%, intermittent claudication--in 19.0%, aneurism of the abdominal aorta--in 7.6%, documented atherosclerotic affection of the upper limb arteries--in 2.8%. Patients with intermittent claudication were characterized by significantly less GFR compared to that in patients without clinical symptoms of affected arteries of the lower limbs (38.6 +/- 8.2 and 44.6 +/- 7.3 ml/min, respectively; p < 0.01).
CONCLUSION: Basic symptoms of cardiorenal syndrome in IRD are high rate of cardiovascular risk factors, some of them provoke aggravation of glomerular endotheliocyte dysfunction and deterioration of intrarenal hemodynamics leading to GFR reduction underlying appearance of new endothelium-tropic risk factors (hyperhomocysteinemia), and progression of atherosclerotic process with formation of its special clinical forms (intermittent claudication).
MATERIAL AND METHODS: In examination of 105 IRD patients (63 males and 42 females, mean age 63.8 +/- 5.1 years) we estimated body mass index (BMI), indices of peripheral blood and urine, blood biochemistry, glomerular filtration rate (GFR). Plasmic homocystein concentration was measured in 30 patients. We also studied incidence of some cardiovascular risk factors, clinical variants of atherosclerosis and their correlation with GFR.
RESULTS: IRD patients most frequently had hypertriglyceridemia (67.6%), hypercholesterinemia (53.3%), smoking (47.1%), obesity (41.9%), metabolic syndrome (38.1%), type 2 diabetes mellitus, arterial hypertension of the third degree (70.6%), isolated systolic arterial hypertension (46.7%). GFR was significantly lower in smokers (p < 0.001), arterial hypertension of the third degree (p < 0.05), isolated systolic arterial hypertension (p < 0.001) and type 2 diabetes mellitus (p < 0.05). In GFR < 40 ml/min homocysteinemia increased significantly (p < 0.01). Coronary artery disease in IRD occurred in 52.4%, cerebrovascular diseases (brain stroke, transitory ischemic attacks)--in 29.5%, intermittent claudication--in 19.0%, aneurism of the abdominal aorta--in 7.6%, documented atherosclerotic affection of the upper limb arteries--in 2.8%. Patients with intermittent claudication were characterized by significantly less GFR compared to that in patients without clinical symptoms of affected arteries of the lower limbs (38.6 +/- 8.2 and 44.6 +/- 7.3 ml/min, respectively; p < 0.01).
CONCLUSION: Basic symptoms of cardiorenal syndrome in IRD are high rate of cardiovascular risk factors, some of them provoke aggravation of glomerular endotheliocyte dysfunction and deterioration of intrarenal hemodynamics leading to GFR reduction underlying appearance of new endothelium-tropic risk factors (hyperhomocysteinemia), and progression of atherosclerotic process with formation of its special clinical forms (intermittent claudication).