Особливості перебігу хронічної хвороби нирок у пацієнтів з артеріальною гіпертензією, цукровим діабетом та хронічним гломерулонефритом

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Chronic kidney disease (CKD), especially its terminal stage, is a serious problem in modern medicine. There are certain features of the course of CKD in patients with arterial hypertension (AH), diabetes mellitus (DM), and chronic glomerulonephritis (CGN). The purpose of the study was to study the course of CKD against the background of hypertension, diabetes and chronic hypertension based on clinical and laboratory examination data to assess the severity of the patients' condition. Materials and methods. 86 patients with stage V chronic renal failure (CKD) were examined, who were divided into 3 groups depending on the existing concomitant disease. Group 1 (n – 35) included patients with CKD and hypertension, group 2 (n – 28) – patients with CKD and diabetes, and group 3 (n – 23) – patients with CKD and CGN. Anthropometric, general clinical, laboratory and instrumental research methods were performed on all patients. Research results and their discussion. Analyzing the data of a general blood test, 100 % of patients in all three groups had a decrease in hemoglobin and erythrocyte levels. A significant decrease in the level of albumin (p < 0.05) and an increase in the levels of urea (p < 0.001) and creatinine (p < 0.001) were also found, which indicated a pronounced decrease in kidney function and significant kidney damage. Analyzing the results of the ionic composition of the blood, a significant increase in the levels of phosphorus and parathyroid hormone was found in patients of the III group (CNN and CGN). Conclusions: 1. In all groups of patients with CKD of the V degree in combination with concomitant hypertension, diabetes mellitus or CGN, persistent anemia was noted, which was manifested by a progressive drop in hemoglobin to the levels of 86.22 ± 3.61 g/l, 83.89 ± 3.06 g/l and 83.22 ± 3.49 g/l, respectively. 2. In such patients, a pronounced decrease in kidney function was noted, which was manifested by a delay in the release of the products of protein metabolism from the blood due to a decrease in the levels of albumin (p < 0.05), a significant increase in the levels of urea (p < 0.001), creatinine (p < 0.001) and a decrease glomerular filtration rate. 3. In the group of patients with a combination of CKD stage V and CGN, a significant increase in phosphorus and parathyroid hormone levels was found (p < 0.01). Such an increase in the level of parathyroid hormone in blood serum may be associated with a drop in the level of calcium in the blood of such patients and the subsequent progressive increase in the level of inorganic phosphate and the development of hyperphosphatemia.