Influence of excessive salt intake on the change of tubulointerstitial kidney tissue in hypertensive patients. Morphological study


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Abstract

Aim. Identification of the relationship between excessive salt intake and signs of kidney TIT damage (degree of inflammation, fibrosis, the degree of activation of sodium transporters) in hypertensive patients. Material and Methods. The collection of morphological material - kidney and small intestine - in sudden death cases, with further histological and immunohistochemical studies, was performed (the following markers were determined: tubular NF-kB, TGF-ß,, MCP-і, Osteoponin, Na+,K+-ATPase, ТНР, NНЕ-3). study included 10 men and 8 women. The mean age was 40±10 years, the mean waist measurment - 102±12.5 cm, and mean height - 170±7.7 cm. Results. In the study group compared to the control group, there was increase in the intensity of expression of inflammatory markers in kidney tit (1.9-fold increase in tubular NF-kB, 2.1-fold increase in TGF-ß,, 1.6-fold increase MCP-і, 3.8-fold increase in ТНР and 1.6-fold increase in osteoponin levels), and their relationship with the sodium transporter marker levels was revealed (the most significant statistical relationship of ТНР and MCP-і marker levels with the activity of sodium transporter markers); the increase in the activity of transporter markers (1.3-fold increase in kidney Na+, K+-ATPase level, 1.8-fold increase in intestinal NHE-3 level, and 3-fold increase in intestinal Na+, K+-ATPase level) was determined, which confirms the in-life excessive salt intake. The most significant markers, whose level influences the intensity of inflammation in the kidney tit, included a combination of a high sodium transporter marker levels, Na+, K+-ATPase in the kidney and NHE-3 in the intestine. Conclusions. The results of this study show a clear relationship between the level of expression of sodium transporter markers and the level of expression of inflammatory markers of the kidney tit, which in turn is related to the severity of ah. It was shown that kidney tit damage already presents in ah of the 1st stage.

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About the authors

A. V Sokolova

FSBEI HE "Russian National Scientific Medical University n.a. N.I. Pirogov” of RMH; SBI "Scientific Research Institute of Health Organization and Medical Management of the Moscow Healthcare Department"

PhD in Medical Sciences, Teaching Assistant at the Department of Propaedeutics of Internal Diseases, General Physiotherapy and Radiation Diagnostics of the Pediatric Faculty; Leading Specialist at the Organizational and Methodological Department for the Therapy

D. O Dragunov

FSBEI HE "Russian National Scientific Medical University n.a. N.I. Pirogov” of RMH; SBI "Scientific Research Institute of Health Organization and Medical Management of the Moscow Healthcare Department"

PhD in Medical Sciences, Associate Professor at the Department of Propaedeutics of Internal Diseases, General Physiotherapy and Radiation Diagnostics of the Pediatric Faculty; Head of the Organizational and Methodological Departmentfor the Therapy

G. P Arutyunov

FSBEI HE "Russian National Scientific Medical University n.a. N.I. Pirogov” of RMH

Doctor of Medical Sciences, Professor, Corresponding Member of RAS, Head of the Department of Propaedeutics of Internal Diseases, General Physiotherapy and Radiation Diagnostics of the Pediatric Faculty

S. A Rumyantsev

FSBEI HE "Russian National Scientific Medical University n.a. N.I. Pirogov” of RMH

Doctor of Medical Sciences, Professor, Corresponding Member of RAS, Vice-Rector for Strategic Development

I. P Papyshev

SBHCI "Office of the Chief Medical Examiner of the Moscow Healthcare Department"

PhD in Medical Sciences, Head of the thanatological Department

E. M Kildyushov

SBI "Scientific Research Institute of Health Organization and Medical Management of the Moscow Healthcare Department"

Doctor of Medical Sciences, Professor, Head of the department of Forensic Medicine of the Medical Faculty

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