O. Matova, K. Serbeniuk, L. V. Bezrodna, V. Bezrodnyi, V. Radchenko
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引用次数: 0
Abstract
Resistant hypertension and chronic kidney disease are closely related from a pathogenetic and clinical point of view. To study the dynamics of functional state of kidneys and as well as to identify the predictors of its improvement, 117 patients with resistant hypertension were examined. Dynamic follow−up of patients included monitoring of antihypertensive therapy, blood pressure, biochemical and humoral parameters during 3, 6 and 36 months of treatment. The findings have shown that a significant long−term improvement in blood pressure control in the patients with chronic kidney disease improves their function and also has a nephroprotective effect in patients without any signs of renal damage. The established prognostic value of the higher initial creatinine content for the improvement of renal function in patients with resistant hypertension is stipulated with a positive effect of antihypertensive therapy on the glomerular filtration rate dynamics. The close association between improved renal function and lower baseline levels of interleukin 6 as well as an active renin in the blood may indicate a role for systemic inflammation and renin−angiotensin−aldosterone system activity in the renal dysfunction development. Prolonged improvement in blood pressure control in the patients with resistant hypertension without diabetes is associated with a stable level of urinary albumin excretion, whereas in patients with diabetes, an albuminuria increases over time. The study concluded that independent predictors of improved renal function in patients with resistant hypertension are higher baseline creatinine and lower glomerular filtration rate, lower concentrations of interleukin 6, active renin and plasma potassium.
Key words: resistant arterial hypertension, chronic kidney disease, functional state of kidneys, antihypertensive therapy.
期刊介绍:
The International Medical Journal is intended to provide a multidisciplinary forum for the exchange of ideas and information among professionals concerned with medicine and related disciplines in the world. It is recognized that many other disciplines have an important contribution to make in furthering knowledge of the physical life and mental life and the Editors welcome relevant contributions from them.
The Editors and Publishers wish to encourage a dialogue among the experts from different countries whose diverse cultures afford interesting and challenging alternatives to existing theories and practices. Priority will therefore be given to articles which are oriented to an international perspective. The journal will publish reviews of high quality on contemporary issues, significant clinical studies, and conceptual contributions, as well as serve in the rapid dissemination of important and relevant research findings.
The International Medical Journal (IMJ) was first established in 1994.