FEATURES OF THE STRUCTURAL AND THE FUNCTIONAL STATE OF KIDNEYS AND THE FUNCTION OF ENDOTHELIUM IN HYPERTENSIVE PATIENTS WITH METABOLIC DISTURBANCES

Abstract

THE AIM : to study the features of the structural and the functional state of the kidneys in relation to the functional state of the endothelium in patients with arterial hypertension (AH) in combination with metabolic disorders. PATIENTS AND METHODS . The study included 351 patients with AH in the age from 40 to 70 years old with unachieved target values of arterial blood pressure (BP). Patients were divided into four groups, comparable in age, sex, frequency of smoking, duration of AH, the level of office systolic blood pressure (SBP) and diastolic blood pressure (DBP), depending on the presence of concomitant diseases: obesity, MS, type 2 diabetes. Clinical examination with analysis of the body composition was performed, structural and functional parameters of the kidneys, functional state of the endothelium were determined. RESULTS . The study revealed regular features of changes in the structural and functional parameters of the kidneys in patients with “isolated” AH and in individuals with AH in combination with comorbid pathology in the form of a statistically significant increase of kidney volume, percentage of patients with an uneven contour of the kidneys, impaired structure and changes in echogenicity of the parenchyma, decrease tubular and glomerular functions of the kidneys when AH combines with metabolic disorders. We noted parallelism in structural and functional changes of the when MS components were attached to the AH. CONCLUSION. The revealed reliable correlation relationships between the structural and functional state of the kidneys and endothelial dysfunction confirm the progression of renal and endothelial damage when MS components are associated with AH.