Состояние функции почек у больных туберкулезом легких

Abstract

Objective: to evaluate the functional state of the kidneys in patients with various clinical variants of pulmonary tuberculosis. Material and methods. 60 patients with pulmonary tuberculosis were examined: 32 people with disseminated forms (53.3%), 16 people with infiltrative pulmonary tuberculosis (26.6%) and 12 people with other forms of pulmonary tuberculosis (20.0%). The average age of patients was 54.3 ± 3.3 years. The examination included a complete clinical, laboratory and instrumental examination. The glomerular filtration rate (GFR) was evaluated using the CKD-EPI formula, followed by an assessment of the stage of chronic kidney disease (CKD) in accordance with National Clinical Guidelines (Moscow, 2019). Results and discussion. As a result of the examination, CKD of various stages was detected in all observed patients with pulmonary tuberculosis. CKD of stage C2 (35.0%) and C3a (31.6%) was most often detected, less often C3b (6.6%), C4 (15%) and C5 (11.6%). At the same time, patients with disseminated forms of pulmonary tuberculosis were more likely to have more severe stages of CKD (C3b – C5) – 18.2%, than in patients with infiltrative forms (6.5%) and in patients with other forms of pulmonary tuberculosis (8.3%). The development of CKD in patients with pulmonary tuberculosis can contribute to the formation of morphofunctional changes in the lung tissue with fibrosis phenomena and subsequent violations of ventilation and perfusion mechanisms. Conclusion. The results obtained require mandatory assessment of kidney function in patients with pulmonary tuberculosis with the determination of the glomerular filtration rate by the calculated method, followed by the isolation of the CKD stage, especially in patients with a disseminated form of the disease, and timely measures to slow the progression of CKD.