POSSIBILITIES OF DIFFERENTIAL DIAGNOSIS OF DIABETIC AND ATHEROSCLEROTIC ANGIONEPHROSCLEROSIS BASED ON ECHOCONTRASTY OF THE KIDNEYS AND ULTRASOUND EXAMINATION OF THE MAIN VESSELS OF THE NECK

Abstract

Relevance. Currently, atherosclerosis is one of the leading causes of mortality and disability of the population. Since diabetic angionephrosclerosis in patients with DM develops for a long time and mainly in patients of the age group of the population, a differential diagnosis between diabetic and atherosclerotic angionephrosclerosis is necessary, which is reflected in the patent for the invention (patent RU No. 2785489). Aim of the research. To evaluate the effectiveness of a new method of differential diagnosis of diabetic and atherosclerotic angionephrosclerosis based on echocontrasty of the kidneys and ultrasound examination of the vessels of the neck. Materials and methods. In the period from 2019 to 2022, 86 people were examined, who underwent a comprehensive clinical laboratory and multiparametric ultrasound examination with subsequent assessment of the diagnosis of angioedema according to the original technique (Patent No. 2785489). All patients underwent a comprehensive diagnosis, including: collection of complaints and anamnesis, lipidogram, laboratory biochemical examination (capillary blood glucose mmol / L, glycated hemoglobin (HbA1c, %), multiparametric ultrasound examination of the kidneys in B-mode with further Doppler assessment of the state of hemodynamics in the renal vessels, ultrasound of the intima-media complex carotid artery. Results and discussions. As a result of the study, the patients were divided into 2 groups: group 1 (n = 44) – patients with glucose levels ≥ 6.1 mmol/l; group 2 (n = 42) – patients with glucose levels ≤6.1 mmol/l. As a result of complex clinical and laboratory and multiparametric ultrasound examination, combined with contrast-enhanced ultrasound examination of the kidneys, the differential diagnosis of atherosclerotic and diabetic angionephrosclerosis was evaluated according to the proposed method. Diabetic angionephrosclerosis was detected in 31.81% of group 1 patients, and atherosclerotic angionephrosclerosis was detected in 11.3% of patients. In group 2, 69.04% had atherosclerotic angionephrosclerosis, diabetic angionephrosclerosis was not detected in any of their studied group 2 patients. Conclusions. 1. Thus, using the method of differential diagnosis of diabetic and atherosclerotic angionephrosclerosis (patent RU No. 2785489), it allows to separate diabetic and atherosclerotic angionephrosclerosis, as well as to correct diagnostic and therapeutic tactics of patient management with the possibility of preventing early vascular complications. 2. The proposed method of differential diagnosis of diabetic and atherosclerotic angionephrosclerosis allows monitoring the effectiveness of treatment of most diabetic and atherosclerotic angionephropathy.