Glomerular fi ltration rate and erythrocyte sedimentation rate in various bronchial asthma variants

Abstract

BACKGROUND. Previously, we postulated the common pathogenetic mechanisms in bronchial asthma (BA) and chronic kidney disease (CKD). Given that both the glomerular filtration rate and the erythrocyte sedimentation rate directly depend on the rheological properties of the blood, it was of interest to compare these two important characteristics in different types of bronchial asthma. At the same time, we considered the erythrocyte sedimentation rate (ESR) not only as a factor in systemic inflammation, but also as a model of erythrocyte aggregation and hemorheology. THE AIM: to compare the level of glomerular filtration rate and erythrocyte sedimentation rate in different types of BA. PATIENTS AND METHODS. 215 BA patients with various BA variants were examined. The glomerular filtration rate (eGFR) was calculated using CKD-EPI. Erythrocyte sedimentation rate (ESR) was determined by the Panchenkov method. The integral eGFR/ESR index was used as the ratio of eGFR and ESR values in each individual patient. RESULTS. The glomerular filtration rate is significantly reduced, and the ESR values are significantly higher in non-allergic and hormone-dependent BA compared with the allergic variant of the disease. In the same groups of patients, a significant decrease in the eGFR/ESR index was revealed. Factor analysis revealed that Factor 1, which characterizes the non-allergic variant of BA, had the component of the eGFR/ESR index with a very high negative factor load along with a high negative factor load of the FEV1 component. Factor 2 reflects the features of endothelial dysfunction in the allergic variant of BA, the allergic variant of BA, and the component of the eGFR/ESR index has practically no factor load in this factor. Factor 3, reflecting the manifestations of an atopic state, with a positive factor load, includes a component of the eGFR/ESR index. CONCLUSION. The data obtained suggest that the development of CKD in bronchial asthma depends primarily on the variant of the disease. The decrease in the eGFR/ ESR index in non-allergic and hormone-dependent variants of BA compared with the allergic variant of the disease indicates the involvement of blood microrheological properties to the development of CKD in these two variants of the disease. On the contrary, in the allergic variant of BA, the development of CKD under these conditions can be restrained.