Renal function deterioration factors in patients with arterial hypertension
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
The objective: to investigate the factors affecting renal function deterio ration in patients with essential hypertension.
Patients and methods. 52 patients at the age of (65,8±1,2) years with hypertensive nephropathy with glomerular filtration rate 65,8±1,2 ml/min were examined. The study was conducted at the basic state, after 3 and 12 months of treatment and after 12 months of outpatient treatment stage. All patients were examined as follows: blood pressure measurement and pulse pressure assessment, micro and macroalbuminuria, uric acid, creatinine, glomerular filtration rate were also investigated. As the antihypertensive therapy, losartan was administered at 100 mg per day.
Results. After 3 months of treatment with angiotensin II receptor antagonist losartan a significant decrease in blood pressure and antihy pertensive effect increasing at 12 months were revealed. Against the background of treatment with losartan we noted positive dynamics of renal functional state. After 12 months of outpatient treatment, it was noted that the level of blood pressure in patients returned to the basic values as patients were treated inefficiently. |Blood pressure destabilization in patients was accompanied by a significant deterioration of renal function. By the end of the study it was noted that the factors influencing the progression of renal disease in patients with hypertensive nephropathy are – the initial renal function state, uric acid levels, and pulse pressure levels.
Conclusion. The use of angiotensin II receptor antagonist losartan slows hypertensive renal damage progression and ineffective antihypertensive therapy led to leveling of the achieved renoprotective effect. The rate of renal function decreasing is associated with baseline eGFR and pulse pres sure levels.
##plugins.themes.bootstrap3.article.details##
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Коломієць М.В. Фактори, які впливають на розвиток порушень обміну ксантинів у хворих на хронічну серцеву недостатність з та без супутньої хронічної хвороби нирок / М.В. Коломієць // Експериментальна і клінічна медицина: науково-практичний журнал. – 2013. – No 4. – С. 72–75.
Ларина В.Н. Гиперурикемия и сердечно-сосудистый континуум / В.Н. Ларина, Б.Я. Барт, В.Г. Ларин, А.С. Донсков // Клиническая медицина. – 2013. – No 1 (Т. 91). – С. 11–15.
Міщенко Л.А. Предиктори погіршання функціонального стану нирок у хворих на гіпертонічну хворобу з гіпертензивною нефропатією / Л.А. Міщенко, Є.П. Свіщенко, В.Б. Безродний // Український кардіологічний журнал. – No 1. – 2012. – С. 8–11
Сіренко Ю.М. Функція нирок у хворих з артеріальною гіпертензією: методи дослідження та стратегічні підходи до лікування. Частина I / Ю.М. Сіренко, Г.Д. Радченко, В.М. Граніч // Укр. кардіол. журн. – 2005. – No 4. – С. 10–18.
Benetos A. Pulse pressure. A predictorof long termcardiovascular mortality in a French male population / A. Benetos, M. Safar [et al.] // Hypertension. – 2007. – Vol. 30. – Р. 1410?1415.
Guidelines for the management of arterial hypertension. The task force for the management of arterial hypertension of the ESH and ESC // J. Hypertens. – 2007. – Vol. 25, No 6. – P. 1105–1187.
Mazzali M. Hyperuricemia induces a primary arteriolopathy in rats by a blood pressure – independent mechanism / M. Mazzali, J. Kanellis, L. Han [et al.] // Amer. J. Physiol. Renal. Physiol. – 2002. – Vol. 282. – P. 991–997.
National Kidney Foundation. Kidney Disease Outcomes Quality Initiative. K/DOQI clinical practice gidelines on hypertension and antihypertensive agents in cronic kidney disease // Amer. J. Kidney Dis. – 2004. – Vol. 43 (Suppl. 1). – P. 1–290.
Williams B. Differential impact of blood pressure lowering drugs on central aortic pressure and clinical out comes: principal results of the Conduit Artery Function Evaluation (CAFE) study / B. Williams // Circulation. – 2006. – Vol. 113. – P. 1213–1225.
Wright J.T. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease / J.T. Wright, G. Bakris, T. Green [et al.] // JAMA. – 2002. – Vol. 288. – P. 2421–2431.
Young J.H. Blood pressure and decline of kidney function: findings from the Systolic Hypertension in the Elderly Programm (SHEP) / J.H. Young, M.G. Klag, P. Muntner [et al.] // J. Amer. Soc. Nephrol. – 2002. – Vol. 13. – P. 2776–2782.
