The level of proteinuria and the state of endothelial function in patients with chronic kidney disease combined with subclinical hypothyroidism under the influence of combined antihypertensive therapy.

Authors

  • O. V. Kuryata
  • I. P. Garmish

DOI:

https://doi.org/10.26641/2307-0404.2018.2(part1).129510

Keywords:

chronic kidney disease, arterial hypertension, subclinical hypothyroidism, combined antihypertensive therapy

Abstract

Our aim was to assess the level of proteinuria and changes in vascular endothelial function in patients with chronic kidney disease (CKD) in combination with subclinical hypothyroidism (SHT) under the influence of antihypertensive combination therapy (valsartan 160 mg and amlodipine 5 mg). We examined 48 patients with CKD I-II stages and AH 1 and 2 degrees. Depending on the functional state of the thyroid gland, patients were divided into 2 groups. Within 12 weeks patients took a fixed combination of amlodipine 5 mg and valsartan 160 mg. Target BP levels were achieved in 19 (86.3%) patients of the main group and 22 (84.6%) of the comparison group. More often violation of brachial artery flow-mediated dilation and higher level of daily proteinuria were found in the main group patients. At the end of the study, the level of daily proteinuria in the main group decreased by 46.03% (p<0.01), and in the comparison group – by 55.3% (p<0.01). SHT can be considered as an additional factor that affects the course of CKD and AH by worsening the state of endothelial function and increasing the level of daily proteinuria. Combination of valsartan 160 mg and amlodipine 5 mg has lead to achieving of target blood pressure levels, improving of endothelial function and decreasing of daily proteinuria in both groups.

 

Author Biographies

O. V. Kuryata

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Internal Medicine 2
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

I. P. Garmish

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Internal Medicine 2
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

References

Kuryata OV, Karapetjan KG, Bardachenko NI, Garmish IP. [Possibilities of correction of cognitive func­tions and anxiety-depressive disorders in the complex therapy of arterial hypertension, depending on the func­tional state of the kidneys]. Journal of neuroscience of BM Mankovskyi. 2015;3(3):5-10. Russian.

Zaremba Je, Zaremba-Fedchyshyn O, Virna M. [Op­timization of combined antihypertensive therapy in patients with arterial hypertension, depending on the indicators of daily blood pressure monitoring]. Semejnaja medycyna. 2017;2 (70):67-71. Ukrainian.

Kuryata OV, Garmish IP. [The effectiveness of combined antihypertensive therapy in patients with chro­nic kidney disease combined with subclinical hypo­thyroidism]. Semeynaya meditsina. 2017;3(71):22-27. Ukrainian.

Кushnir JS. [Hemodynamics, functional state of the endothelium, kidneys and platelets depending on the body mass index in patients with chronic heart failure with preserved systolic function]. Medicni perspektivi. 2014;ХІХ(1):29-36. Ukrainian.

Lapshin OV. [Combined antihypertensive therapy - a modern trend of treatment]. Liky Ukrainy. 2013;1(167):30-37. Ukrainian.

Whelton PK, Carey RM, Aronow WS, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of theAmericanCollegeof Cardiology. American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;13.

Cooper D, Biondi B. Subclinical thyroid disease. Lancet. 2012;379(9821):1142-54.

Leung AA, Daskalopoulou SS, Dasgupta K, et al. Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hyper­tension in Adults. Canadian Journal of cardiology. 2017;33(5):557-76.

Chongol M, Lippi G, Salvagno G, Zoppini G, Michele M, Giovanni T. Prevalence of Subclinical hypo­thyroidism in patients with chronic kidney disease. Clin J Am Soc Nephrol. 2008;3(5):1296-300.

How to Cite

1.
Kuryata OV, Garmish IP. The level of proteinuria and the state of endothelial function in patients with chronic kidney disease combined with subclinical hypothyroidism under the influence of combined antihypertensive therapy. Med. perspekt. [Internet]. 2018May24 [cited 2024Apr.20];23(2(part1):19-24. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/129510

Issue

Section

CLINICAL MEDICINE