Clinical value of erythrocitary indices in chronic glomerulonephritis


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. Evaluation of the clinical and laboratory features of erythrocyte indices and structural restructuring of the left ventricular myocardium in patients with chronic glomerulonephritis depending on gender differences. Material and methods. A total of 305 patients with chronic glomerulonephritis (CGN) at the pre-dialysis stage of chronic kidney disease (CKD) were included in the study, there were 206 men (Group 1) and 99 women (Group 2). All patients underwent general clinical and echocardiographic examinations. Results. Patients of group 1 (men) had higher diastolic blood pressure (P=0.004), indexed left ventricular (LV) myocardial mass (P=0.005), LV hypertrophy (P=0.005), and concentric left ventricular hypertrophy (P = 0.005) compared with patients of group 2 (women). At the same time, the double product index was significantly higher in the group of women (P=0.027). A significant decrease in the hemoglobin level (P=0.005), hematocrit (P=0.005), the number of erythrocytes (P=0.005), platelets (P=0.045) and a decrease in the diameter of erythrocytes (P=0.005) were detected in the group of women. At the same time, in this group, there was a noticeable slowdown in the glomerular filtration rate (GFR) (P=0.005) and a decrease in the relative urine density (P=0.005). A close relationship between the diameter of erythrocytes and the GFR value in both men and women was found. In the general group, a negative relationship between the erythrocyte diameter and the double product index was recorded (r= -0.156; P=0.016). Both in the group of men and women, a decrease in the erythrocyte diameter was accompanied by an increase in LVMMI (r= -0.167; P=0.033 and r = -0.264; P=0.020, respectively). Conclusion. A decrease in the erythrocyte diameter, a decrease in the hemoglobin level in female patients with chronic glomerulonephritis were accompanied by a significant slowdown in GFR and an increase in cardiovascular risk (myocardial oxygen demand), and in the group of male patients - with the development of a concentric remodeling and concentric left ventricle hypertrophy, an increase in the plasma uric acid level

Full Text

Restricted Access

About the authors

Ilkhom T. Murkamilov

I.K. Akhunbaev Kyrgyz State Medical Academy; Kyrgyz-Russian Slavic University

Email: murkamilov.i@mail.ru.orcidid:
Cand. Sci. (Med.), Nephrologist, Deputy Associate Professor at the Department of Faculty Therapy

Kuvanych A. Aitbaev

Scientific Research Institute of Molecular Biology and Medicine

Email: kaitbaev@yahoo.com.orcidid:
Doctor of Medical Sciences, Professor, Head of the Laboratory of Pathological Physiology

Victor V. Fomin

Sechenov University

Email: fomin_vic@mail.ru.orcidid:
Corresponding Member of the Russian Academy of Sciences, Dr. Sci. (Med.), Professor, Head of the Faculty Therapy Department № 1

Gulnara S. Yusupova

I.K. Akhunbaev Kyrgyz State Medical Academy

Email: gulnara.1953@mail.ru
Cand. Sci (Med.), Associate Professor at the Department of Faculty Therapy

Furkat A. Yusupov

Osh State University

Email: furcat_y@mail.ru.orcidid:
Dr. Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry

References

  1. Mukhin N.A. Nephrology. National leadership. Short edition. М., 2016. 608p.
  2. Smirnov A.V., Dobronravov V.A., Kayukov I.G., et al. Epidemiology andsocial-economical aspects of chronic kidney disease. Nephrol. 2006;10(1):7-13.
  3. Minutolo R., Locatelli F., Gallieni M., et al. Anaemia management in nondialysis chronic kidney disease (CKD) patients: a multicentre prospective study in renal clinics. Nephrol. Dial. Transplant. 2013;28(12):3035-45. doi: 10.1093/ndt/gft338.
  4. Delanaye P., Glassock R.J., De Broe M.E. Epidemiology of chronic kidney disease: think (at least) twice!. Clin. Kidney J. 2017;10(3):370-74. doi: 10.1093/ckj/sfw154.
  5. Lehmus T.Yu, Germash E.I., Kilmetova R.R., et al. Chronic kidney disease: problems and their solution. Bull. Bashk. State Med. Univers. 2014;1(Annex 1):64-72.
  6. Aitbaev K.A., Murkamilov I.T., Fomin V.V., et al. The nephrogenic anemia: progression in comprehension of pathophysiology and a potential of the new approaches to safe therapy. Klin. Lab. Diagn. 2017;62(12):735-41. doi: 10.18821/0869-2084-2017-62-12-735-741.
  7. National Kidney Foundation. K/DOQI clinical practice guidelines and clinical practice recommendations for anaemia in chronic kidney disease. Am. J. Kidney. Dis. 2006;47:(Suppl. 3):S1-146.
  8. Valderrabano F., Hörl W.H., Macdougall I.C., et al. Pre-dialysis survey on anaemia management. Nephrol. Dial. Transplant. 2003;18:89-100. doi: 10.1093/ndt/18.1.89.
  9. Zadrazil J., Pavel H. Pathophysiology of anemia in chronic kidney diseases: A review. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc. Czech. Repub. 2015;159:(2):197-202. doi: 10.5507/bp.2013.093.
  10. McClellan W., Aronoff S.L., Bolton W.K., et al. The prevalence of anemia in patients with chronic kidney disease. Curr. Med. Res. Opin. 2004;20(9):1501 10. doi: 10.1185/030079904X2763
  11. Kozlovskaya L.V., Milovanov Yu.S., Fomin V.V., et al. Cardiovascular effects of erythropoietin in patients with a conservative stage of chronic renal failure. Doctor. 2004;10:57-9
  12. Aitbaev K.A., Murkamilov I.T., Fomin V.V. Anemia of chronic kidney disease: novel physiological approaches to therapy based on simulation of hypoxic response. Almanac of Clin. Med. 2217;45(7):565-74. doi: 10.18786/20720505-2017-45-7-565-574)
  13. Gasanov M.Z., Kolomyitseva M.N., Batyushin M.M. The Role of Uremic Intoxication in the Development of Cardiovascular Remodeling in Patients with Chronic Kidney Disease Stages 3a-5d.Rus. Arch.Int. Med. 2021;11(5):370 79. doi: 10.20514/2226-6704-2021-11-5-370-379
  14. Milovanov Yu.S., Milovanova L.Yu., Kozlovskaya L.V. Nephrogenic anemia: pathogenesis, prognostic significance, principles of treatment. Clin. Nephrol. 2010;6:7-18.
  15. Atkinson M.A., Warady B.A. Anemia in chronic kidney disease. Pediatr. Nephrol. 2018;33(2):227-38. doi: 10.1007/s00467-017-3663-y.
  16. Locatelli F., Choukroun G., Fliser D., et al. Dialysis anaemia. Nephrol. Dial. Transplant. 2214;29 (Suppl. 3):iii491-500. doi: 12.1293/ndt/gfu176.
  17. Winearls C., Pippard M., Downing M., et al. Effect of human erythropoietin derived from recombinant DNA on the anemia of patients maintained by chronic haemodialis. Lancet. 1986;8517:1175-78. doi: 10.1016/S0140-6736(86)92192-6.
  18. Pugliese G., Solini A., Bonora E., et al. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation provides a better definition of cardiovascular burden associated with CKD than the Modification of Diet in Renal Disease (MDRD) Study formula in subjects with type 2 diabetes. Atheroscler. 2011;218(1):194-9. doi: 10.1016/j.atherosclerosis.2011.04.035.
  19. Devereux R.B., Alonso D.R., Lutas E.M., et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am. J. Cardiol. 1986;57(6):450-58.
  20. Mancia G., Fagard R., Narkiewicz K., et al. The 2013 ESH/ESCguidelinesfor the management of arterial hypertension. Eur. Heart J. 2013;34:28:2159-219. doi: 10.1093/eurheartj/eht151.
  21. Orlov A.I. Applied statistics [Prikladnaya statistika]. M., 2006.
  22. Cases A., Egocheaga M.I., Tranche S., et al. Anemia of chronic kidney disease: Protocol of study,management and referral to Nephrology. Nefrol. 2018;38(1):8-12. doi: 10.1016/j.nefro.2017.09.004.
  23. Dogara L.G., Hassan A., Awwalu S., et al. Erythropoietic Response to Anaemia of Dialysis Naive Patients with Chronic Kidney Disease in Zaria, NorthWest Nigeria. Niger. J. Clin. Pract. 2018;21:189-94. doi: 10.4103/njcp. njcp_208_17.
  24. Ermolenko V.M., Ivaschenko M.A. Uremia and erythropoietin. M., 2002.
  25. Obrador G.T., Roberts T., Peter W.L.S., et al. Trends in anemia at initiator of dialysis in the United States. Kidney Int. 2001;60:1875-84. doi: 10.1046/j.1523-1755.2001.00002.x.
  26. Fishbane S., Spinowitz B. Update on Anemia in ESRD and Earlier Stages of CKD: Core Curriculum 2018. Am. J. Kidney Dis. 2018;71(3):423-35. doi: 10.1053/j.ajkd.2017.09.026.
  27. Hsu C.Y., McCulloch C.E., Curhan G.C. Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey. Am. Soc. Nephrol. 2002;13:504-51.
  28. Milovanov Y.S., Kozlovskaya L.V., Milovanova L.Y., et al. Risk factors for anemia in the early stages of chronic kidney disease. Ter. Arkh. 2017;89(6):41- 7. doi: 10.17116/terarkh201789641-47.
  29. Jungers P., Choukroun G., Oualim Z., et al. Beneficial influence of recombinant human erythropoietin therapy on the rate of progression of chronic renal failure in predialysis patients. Nephrol. Dial. Transplant. 2001;16(2):307-12. doi: 10.1093/ndt/16.2.307.
  30. Deicher R., Horl W.H. Anaemia as a risk factor for the progression of chronic kidney disease. Curr. Opin. Nephrol. Hypertens. 2003;12(2):139-43.
  31. Mikhail A., Brown C., Williams J.A., et al. Renal association clinical practice guideline on Anaemia of Chronic Kidney Disease. BMC. Nephrol. 2017;18(1).345.
  32. Levin A. The role of anaemia in the genesis of cardiac abnormalities in patients with chronic kidney disease. Nephrol. Dial. Transplant. 2002;17(2):207-10. doi: 10.1093/ndt/17.2.207.
  33. Levin A., Singer J., Thompson C.R., et al. Prevalent left ventricular hypertrophy in the predialysis population: identifying opportunities for intervention. Am. J. Kidney Dis. 1996;27(3):347-54. doi: 10.1016/S0272-6386(96)90357-1.
  34. Akintunde A.A., Aworanti O.W. Pattern of anaemia and its correlates in Nigerians with heart failure. Ann. Ibadan Postgrad. Med. 2020;18(1):51-9.
  35. Tomura M., Hamasaki Y., Komaru Y., et al. Prognostic significance of concentric left ventricular hypertrophy at peritoneal dialysis initiation. BMC. Nephrol. 2021;22(1):1-11. doi: 10.1186/s12882-021-02321-1.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies