Online ISSN: 2515-8260

Keywords : Glomerular Filtration Rate


PREDICTION OF THE DEVELOPMENT OF RENAL DYSFUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE

Kamilova Umida; Nuritdinov Nuriddin; Zakirova Gulnoza

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1368-1374

Purpose. To identify prognostic factors for the development of renal dysfunction (RD) and to develop a method for
assessing and predicting RD in patients with chronic heart failure (CHF).
Methods. A total of 101 patients with functional class I-III (FC) CHF (according to the classification of the New
York Heart Association) were examined. Also, the patients were divided, depending on the glomerular filtration
rate, determined by the calculation method according to the CKD-EPI formula (eGFR), into two groups: patients
with eGFR≥90 ml / min (n = 20), with eGFR <90 ml / min (n = 81). All patients were determined: creatinine (Cr),
eGFR according to the CKD-EPI formula, albumin / creatinine (Al / Cr) level (mg / mmol) in morning urine,
specific gravity in morning urine portion (SG); studied renal blood flow according to Doppler sonography at the
level of the common left and right renal arteries. To assess the significance of signs for determining and predicting
RD in CHF, we used a method based on Wald's sequential statistical analysis with the development of differential
diagnostic tables, determination of diagnostic coefficients (DC) and information content (J) of each sign in groups of
patients with CHF, depending on the level eGFR, determination of diagnostic thresholds (amount of DC).
Results. As a result of the developed differential diagnostic tables, the most informative signs were identified that
determine the unfavorable prognosis of RD in patients with CHF: creatinine above 80 μmol / l, eGFR less than 90
ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine specific gravity SG less than 1015,
resistance index (RI) at the level of the right and left renal arteries more than 0.7. The sum of DCs of these signs,
depending on the severity of symptoms, determines the risk of developing RD: a very high risk in the range from
+15 to +32, high risk - from +8 to +14, moderate risk - from +7 to +3, favorable course of CHF - from 0 to +2
points.
Conclusion. Signs of an unfavorable prognosis for the development of RD in patients with CHF were determined:
creatinine above 80 μmol / l, eGFR less than 90 ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine SG less than 1015, RI at the renal level arteries more than 0.7.

Assessment Of Erythropoietin Efficacy And Dosing In Hemodialysis Patients

Mostafa Fawzy Mohamed Selim; Essam Eldin Mahmoud Lotfy; Lamiaa Abd Elwahab Mohamed; Mahmoud Hosny Zahran

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2461-2469

Background: Anemia is a common complication in Chronic kidney disease (CKD) patients. It has a multi-factorial pathogenesis. Replenishing iron stores and giving ESAs are the main lines of treatment. There is a general agreement on the optimal route for iron supplementation in ESRD patients with the IV route but there is no such agreement on the optimal route for iron supplementation in pre-dialysis CKD patients. Erythropoiesis stimulating agents (ESAs) treatment represent an economic burden and has been linked to possible cardiovascular side effects. This study amid to assessing the efficacy of erythropoietin in treatment of anemia in CKD patients. Methods: A prospective cohort study was conducted in chronic kidney disease patients who had undergone hemodialysis in Met-Ghamr hospital of nephrology from February 2019 to July 2019. Included 50 patients on maintenance hemodialysis, we tested the efficacy through comparing the efficacy low fixed ESA dose (4000 IU IV once weekly) versus high fixed dose (4000 IU IV three times weekly). We divided group into two groups, group A and group B. group A were put on a fixed dose of 4000 IU Epoetin alfa once weekly and group B were put on a fixed dose of 4000 IU Epoetin alfa three times weekly. Results: After 6 months, We found a significant difference in hemoglobin response of the two subgroups in favor of subgroup IID (P = 0.004). Conclusion: That low dose ESAs is less effective in correction of anemia in dialysis patients than high dose ESAs.

Features Of Functional Condition Of Kidney In Patients With Heart Failure Reckoning On The Representation Of The Components Of Metabolic Syndrome

Botir T. Daminov; Nodir U. Kayumov; Gulchekhra A. Atakhodjaeva; Umida Sh. Usmanova

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 3430-3443

The aim of the study was to review the features of the functional state of the kidneys in patients with cardiopathy, betting on the presentation of the components of the metabolic syndrome. For the research we examined 197 male patients with chronic heart condition (CHF) of ischemic genesis of II-III functional class (FC) in line with NYHA. Metabolic syndrome in patients with chronic heart failure HFmrEF exacerbates impaired renal function, which has developed together of the most pathogenetic links in chronic heart condition. it's been established that because the metabolic syndrome progresses (attachment of T2DM to other components of the metabolic syndrome), the phenomena of functional kidney failure increase. Evidence of the importance of the metabolic syndrome within the nature of the clinical manifestations of chronic coronary failure HFmrEF is that the established dependence of the identified disorders on the severity of the metabolic syndrome.