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Вестник НовГУ > 2011 > №62 > Nanchikeeva M.L., Kozlovskaya L.V., Fomin V.V., Bulanov N.M., Bulanov M.N. Early stage of renal pathology in patients with essential arterial hypertension: diagnostic and monitoring

Nanchikeeva M.L., Kozlovskaya L.V., Fomin V.V., Bulanov N.M., Bulanov M.N. Early stage of renal pathology in patients with essential arterial hypertension: diagnostic and monitoring

УДК 616.12-008.331.1:616.61
N a n c h i k e e v a M. L., K o z l o v s k a y a L. V., F o m i n V. V., B u l a n o v N. M., B u l a n o v M. N. Early stage of renal pathology in patients with essential arterial hypertension: diag-nostic and monitoring // Вестн. Новг. гос. ун-та. Сер.: Меди-цинские науки. 2011. №62. С.69-73.
Basing on the survey of 259 patients with essential arte-rial hypertension (EAH) early clinical diagnostic markers of involvement in the pathological process of the kidneys have been defined. The survey, which included assessment of micro-albuminuria, glomerular filtration rate, investigation of indicators of renal hemodynamics by Doppler method and study of urinary excretion of molecular mediators that reflect patho-physiological processes in the kidney in patients with EAH, helps to set the dynamic characteristics of early hypertensive nephropathy and to define complex of clinical diagnostic markers of the stages of evolution of hypertensive vascular nephropathy. The earliest signs of involvement in the pathological process of the kidneys in patients with EAH are increasing of urinary biomarkers of endothelial dysfunction closely associated with its remodeling of the extracellular matrix of the kidney and microalbuminuria. We can assess the progression of hypertensive kidney disease with the formation of maladaptive remodeling of intrarenal vascular and growth of ischemia of renal kidney by increase of resistance index of interlobar renal arteries, the downward trend in GFR (less than 90 ml/min/1.73 m2), along with increase of urinary excretion of markers of fibrogenesis in the kidney, particularly of collagen of IV type in EAH patients with persistent microalbuminuria. It was noted that the decrease of GFR less than 60 ml/min/1.73m2 is recognized marker of subclinical dysfunction of the kidney in patients with EAH, it is first evidence of the development of chronic kidney disease in these patients that allows to relate this category of patients to group of high risk of progression of hypertensive kidney disease and requires active nephroprotective strategy.
Библиогр. 16 назв. Табл. 4. Ил. 1.

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