ОЦЕНКА ФУНКЦИОНАЛЬНОГО СОСТОЯНИЯ ПОЧЕК У ПАЦИЕНТОВ С ИЗБЫТОЧНОЙ МАССОЙ ТЕЛА И ОЖИРЕНИЕМ

Abstract

The retrospective study analyzed the glomerular filtration rate (GFR) calculated using the formulas of Cockcroft–Gault (ml/min) and Modification of Diet in Renal Disease (MDRD) (ml/min/1.73 м2) in 1504 patients. The patients had been selected from 7124 visitors to the outpatient unit in 2010: those were overweight (body mass index (BMI) 25.0–29.9 kg/m2;n = 657), obese (BMI ≥ 30 kg/m2; n = 615), and normal-weight (BMI 18.5–24.9 kg/м; n = 236) who formed a control group. All the patients were examined in the outpatient unit and the V.Kh. Vasilenko Clinic of Internal Propedeutics, Gastroenterology and Hepatology.Analysis of the mean values of GFR calculated using the Cockcroft Gault formula (ml/min) established that the mean GFR increased with BMI from 95 ml/min in overweight persons to 135 ml/min in morbid obesity; in the control group the mean GFR was 82.5 ml/min. The correlation coefficient was 0.35; р < 0.05. There was a reduction in the GFR calculated using the MDRD formula (ml/min/1.73 м²) in the obese patients compared to the controls (69 and 79.4 ml/min/1.73 м2, respectively). The correlation coefficient was 0.15; р < 0.05. Analysis of the distribution of the stages of chronic kidney disease (CKD) in obese patients with the GFR estimated using the Cockcroft Gault formula (ml/min) ascertained that in the obesity groups there was a preponderance of patients with high GFR; the number of these patients increased with higher BMI from 53 % in overweight to 91.5 % in morbid obesity. The correlation coefficient was 0.26; р < 0.05. Analysis of the distribution of the stages of CKD in obese patients with the GFR calculated using the MDRD formula showed a rise in the number of patients with Stage III CKD (from 12 % in overweight to 22.8 % in obesity; 4.7 % in the control group). Moreover, a group of patients (2 %) with Stage IV CKD in morbid obesity was identified. The correlation coefficient was 0.15; р < 0.05.