ДИАГНОСТИЧЕСКАЯ ЭФФЕКТИВНОСТЬ НОВОГО МЕТОДА ОПРЕДЕЛЕНИЯ ПОВРЕЖДЕНИЯ ПОЧЕК ПРИ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ

Abstract

Objectives. To evaluate diagnostic effectiveness of a complex ultrasound method for determining kidney damage in patients with chronic heart failure (CHF). Material and methods. In 2017-2021 on the basis of the Healthcare Institution «1st City Clinical Hospital» in Minsk, a clinical and instrumental study was performed on 203 patients aged 66 (59; 75) years, of which 111 (54.7%) were women and 92 (45.3%) men. Dynamic ultrasound investigation of the kidneys was carried out in 80 patients with CHF after ≥3 months. Inclusion criteria: sinus rhythm in patients; essential (primary) arterial hypertension; chronic ischemic heart disease; congestive heart failure; informed voluntary consent of the patient to participate in the study. Exclusion criteria: glomerular, tubulointerstitial kidney disease, obstructive uropathy, renal artery stenosis, congenital kidney diseases, history of renal malignancy. Results. The method for determining kidney damage in CHF is based on the concept of establishing a complex of ultrasound signs. It includes an assessment of the total volume of the kidneys, parenchymal thickness, end diastolic blood flow velocity, pulsation index, resistance index in segmental renal arteries, and characterizes kidney damage in patients with normal or slightly reduced glomerular filtration rate (GFR) (categories C1 - C2), chronic kidney disease (CKD) with categories of GFR C3A - C4 and CHF. Conclusions. The method has a high accuracy - 98.3%, which makes it possible to recommend its use when establishing CKD in patients with CHF.