The state of the hemomicrocirculation system and predictive capacity of parameters characterizing it in patients with hypertensive nephropathy

Authors

  • I. M. Fushtey State Institution Zaporizhzhia Medical Academy of Post-graduate education of MoH of Ukraine,
  • О. О. Tokarenko State Institution Zaporizhzhia Medical Academy of Post-graduate education of MoH of Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2015.3.55105

Keywords:

Hypertension, Microcirculation, Laser Doppler Flowmetry

Abstract

Today the diagnostics of microcirculatory disorders in patients with hypertensive nephropathy (HN) is an extremely important issue.

Aim. To evaluate the functional state of hemomicrocirculatory (HMC) system and to analyze predictive capacity of parameters characterizing it in patients with essential hypertension (EH) of II stage accompanied with manifestations of nephropathy.

Methods and results.  155 patients were examined including two main groups of patients with stage II EH of second (n=31) and third (n=31) degree of arterial hypertension (AH) with early signs of nephropathy as well as three comparison groups including patients with essential hypertension stage II of the second (n=31) and third (n=31) degree of hypertension with preserved renal function, and practically healthy individuals (n=31). Albumin/creatinine ratio in urine greater that 30 mg/g was taken as the marker of kidney disorder. The function of HMC system was evaluated by means of laser Doppler flowmetry. It was found that it is typical for patients with HN to show the reduction in tissue perfusion, variability of peripheral blood flow, apparent dysfunctional disorders of the microvascular endothelium, significant neurogenic and myogenic tonus increase. The significant loss of elastic properties of microvessels and pronounced signs of stagnation of blood in the postcapillary segment of microvasculature were also noted. Patients with HN accompanied with the sharp reduction of normocirculatory microcirculation hemodynamic type (HTM) showed increase in the cases of spastic and stagnant-stasis HTM.

Conclusions. Among the analyzed parameters which characterize HMC system, A max E and A max C appeared to be the most qualitative predictors of the HN in hypertensive patients and had a joint predictive potential.

References

Sirotin, B. Z., & Zhmereneckij, K. V. (2008) Mikrocirkulyaciya pri serdechno-sosudistykh zabolevaniyakh [Microcirculation in cardiovascular diseases]. Habarovsk. [in Russian].

Chernukh, A. M., Aleksandrov, P. N., & Alekseev, O. V. (1984) Mikrocirkulyaciya [Microcirculation]. Moskva: Medicina. [in Russian].

Makolkin, V. I., Podzolkov, V. I., & Bran'ko, V. V. (2004) Mikrocirkulyaciya v kardiologii [Microcirculation in cardiology]. V. I. Makolkin (ed). Moskva: Vizart. [in Russian].

Serné, E. H., de Jongh, R. T., Eringa, E. C., IJzerman, R. G., Stehouwer, C. D. (2007) Microvascular dysfunction: a potential pathophysiological role in the metabolic syndrome. Hypertension, 50(1), 204–211. doi: 10.1161/HYPERTENSIONAHA.107.089680.

Beloglazova, I. P., Mogutova, P. A., & Poteshkina, N. G. (2012) Patogeneticheskie osnovy kardiorenal'nogo sindroma [The pathogenetic bases of cardiorenal syndrome]. Terapevticheskij arkhiv, 9, 97–103. [in Russian].

Nanchikeeva, M. L. (2010) Rannyaya stadiya porazheniya pochek u bol'nykh gipertonicheskoj bolezn'yu: klinicheskoe znachenie, principy profilaktiki (Avtoref. dis… dokt. med. nauk) [Early stage renal disease in hypertensive patients: clinical significance, principles of prevention Dr. med. sci. diss.]. Moscow [in Russian].

Dzyak, G. V., & Kaplan, P. A. (2012) Kardiorenal'nyj sindrom: patofiziologiya, verifikaciya, podkhody k lecheniyu [Cardiorenal Syndrome: Pathophysiology, Verification, Approaches to Treatment]. Pochki, 1, 9–18. [in Ukrainian].

Krutikov, E. S., Chistyakova, S. I., & Filippov, A. V. (2012) Nefropatiya u bol'nykh arterial'noj gipertenziej, sovremennyj vzglyad na problemu [Nephropathy in patients with hypertension, the modern approach to the problem], 15(2), 3(58), 310–314. [in Ukrainian].

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How to Cite

1.
Fushtey IM, Tokarenko ОО. The state of the hemomicrocirculation system and predictive capacity of parameters characterizing it in patients with hypertensive nephropathy. Pathologia [Internet]. 2015Dec.18 [cited 2024Nov.22];(3). Available from: http://pat.zsmu.edu.ua/article/view/55105

Issue

No. 3 (2015)

Section

Original research

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