Vol 12, No 3 (2020)

Objective. comparatively study the structure of cardiovascular pathology in patients with stage 5 ckd receiving programmed hemodialysis of the rural and urban population of the republic of Uzbekistan. material and methods. 165 patients with stage 5 ckd receiving hemodialysis were examined. patients were divided into two groups depending on their permanent place of residence: urban and rural. the study of patients from the urban population was carried out in two large republican centers in Tashkent and the rural population was studied in the regional multidisciplinary medical center in the city of gulistan. results. According to the results of the study, cardiovascular pathology was determined in 60% of the urban and 39% of the rural population. ah, ihd and hf prevailed in its structure in both groups. also, cvs comorbidity was found in both groups. Conclusion. According to the results of our study, patients in the urban population with CKD5D are more likely to suffer from cardiovascular disease than in the rural population. Comorbid cvs pathology occupies a leading place in the structure of cardiovascular pathology in patients with CKD5D in both urban and rural populations.

Purpose. To analyze the functional state of the kidneys and changes in the cytokine profile in a new coronavirus disease (CO-VID-19). material and methods. a cross-sectional study of 177 patients (96 men and 81 women) with an established diagnosis of covid-19 and pneumonia was carried out. the average age of the examined persons was 48.8±15.2 years. the indices of the calculated glomerular filtration rate (egfr) by blood creatinine were studied, and a single portion of morning urine was analyzed. in 101 (57,0%) patients, the parameters of the cytokine blood profile, including interleukin (IL)-6, -io and tumor necrosis factor alpha (TNF-а), were examined. results. in the examined group of patients with covid-19 and pneumonia, the presence of respiratory failure was noted in 41 (23.i%) patients, anemia - in 32 (18.o%), elevated levels of c-reactive protein and cytokines - in 125 (70.6%) and 31 (30.6%), respectively. a decrease in egfr<60 ml/min/1.73 m2 was found in 13 (7.з%) patients, a severe decrease in gfr - in 9 (5.o%) patients. an insignificant and moderate slowdown in gfr was noted in 22.o and 1.1% of cases, respectively. the optimal egfr level was observed in 125 (70.6%) patients. In the structure of urinary syndrome, persons with hematuria (n=135, 76.2%) and proteinuria (n=57, 32.2%) prevailed. in the urinary sediment of 15 (8.4%) patients, renal epithelial cells were detected. the concentration of il-6 positively correlated with the level of crp and fibrinogen, negatively - with the levels of hemoglobin, hematocrit, the number of erythrocytes, the average hemoglobin content in erythrocytes, and the relative number of lymphocytes. a direct relationship TNF-а concentration was observed with platelet count, absolute lymphocyte count, and proteinuria. An increase in TNF-а concentration was inversely correlated with a decrease in egfr and urine ph. a close relationship was demonstrated between the concentration of crp in the blood and the value of egfr. Conclusions. in patients with covid-19 and sars, hematuria and proteinuria are most commonly reported. among the study participants, 125 (70.6%) patients had optimal renal function. in general, an egfr value of <89 ml/min/1.73 m2 was recorded in 52 (29.3%) patients, WHILE IN 13 (7.3%) THE EGFR LEVEL WAS <60 MUMIN/1.73 M2. TNF-а IS A SIGNIFICANT CYTOKINE THAT AFFECTS THE indicators of renal filtration function and proteinuria.

The article discusses the effectiveness and safety of lipid-lowering therapy in patients with cardiovascular and renal diseases. attention is focused on an inhibitor of cholesterol absorption in the small intestine - ezetimibe. Data on the hypolipidemic and anti-inflammatory effects of ezetimibe and its combination with statins are summarized. Ezetimibe has been shown to have a good safety profile, significantly reducing cardiovascular and cerebral risk, as well as the progression of chronic kidney disease.