LB.03.08] RENAL FUNCTIONAL DISTURBANCIES IN PATIENTS WITH RESISTANT ARTERIAL HYPERTENTION IN COMBINATION WITH RENAL ARTERY ABNORMALITIES

Abstract

Objective: The aim of this study was to assess clinical renal disturbances in patients with resistant arterial hypertension (AH) in combination with renal artery abnormalities (RAA) in 4 years follow-up study. Design and method: 15 patients (6 males, 9 females) aged 44.1 ± 2.0 years with resistant AH (history of AH 16.5 ± 2.1 years) and RAA were examined; ambulatory blood pressure (BP) monitoring (ABPM) mean average of diurnal BP for systolic blood pressure (SBP) and diastolic blood pressure (DBP) as 160.9 ± 3.8 mmHg and 102.8 ± 2.7 mmHg, respectively; BMI 27.9 ± 1.4 kg/m2. The group was compared to the group of patients (n = 28, 11 males and 17 females) with normal renal arteries; aged 45.4 ± 1.8 years, history of AH 14.9 ± 1.3 years; diurnal SBP 158.2 ± 3.6 mmHg and DBP 95.8 ± 2.6 mmHg; BMI 29.3 ± 1.2. BP remained uncontrolled high despite the prescription of 4 antihypertensive drugs. The cases of pseudo-resistant AH had been excluded. Renal function features was evaluated by the dynamic nephroscyntigraphy in all the patients and the level of microalbuminuria was estimated (immunochemical analysis) initially and in 4 years follow-up. Results: Initially the patients with RAA had the level of urine microalbumin 39.38 ± 15.2 mg and in 4 years – 54.74 ± 20.7 mg, respectively (p > 0.05). And in the comparison group the level of microalbuminuria was stated at first point as 51.15 ± 24.9 mg and 4 years later - as 65.45 ± 24.4 mg (p > 0.05). Initially dynamic nephroscyntigraphy analysis presented maximum agent evacuating time (T max) as 6.15 ± 0.8 min and 4 years later – 3.7 ± 0.5 min (p < 0.05). In the comparison group this level was 6.45 ± 0.4 min and 5.7 ± 0.6 min, respectively (p > 0.05). Conclusions: As at first point and as 4 years later the level of microalbuminuria in patients with RAA had no significance differences with the comparison group. Maximum nephroscyntigraphy agent evacuating time (T max) significantly decreased in the main group in the 4 years follow-up period, and in patients with normal renal arteries there were no such changes. The findings may reveal severe growth rate of hypertensive nephrosclerosis of functioning renal parenchyma in patients with resistant AH and RAA.