Right ventricle, pulmonary pressure and their relationship with renal function in patients with overweight and obesity

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Abstract

Background. Overweight, obesity and chronic kidney disease (CKD) are urgent problems of modern medicine.

Objective. Analysis of the relationship between the right ventricle (RV) function, pulmonary pressure and the state of the kidneys in patients with overweight and obesity.

Material and methods. An analysis of clinical, laboratory and echocardiographic data of 305 patients with overweight (n=155) and obesity (n=150), whose mean age was 54.7±11.7 years, was performed. Patients with functional class III–IV chronic heart failure, fever, Lower extremity varicose vein disease, a history of thromboembolic complications, type 1 diabetes mellitus (DM1), liver cirrhosis, nephrotic syndrome, patients on renal replacement therapy, and residents of high-mountain areas were excluded from the study.

Results. Compared with overweight patients, obese patients were more likely to have arterial hypertension (58.0%), DM2 (22.0%) and comorbid diseases (31.3%). This group also had higher diastolic blood pressure (89±11 mmHg vs. 86±11 mmHg; p<0.05), venous blood glucose levels (7.00±3.16 mmol/l vs. 5.76±2.25 mmol/l; p<0.05), triglycerides: 1.66 [1.13; 2.26] mmol/l vs. 1.36 [0.95; 2.25] mmol/l (p<0.05), C-reactive protein – 3.2 [1.6; 7.9] mg/l vs. 2.0 [0.6; 5.3] mg/L (p<0.05), RV size – 2.23±0.40 cm versus 2.09±0.31 cm (p<0.05), pulmonary artery diameter – 2.37±0.38 cm versus 2.24±0.25 cm (p<0.05) and pulmonary systolic pressure – 32.7±12.3 mmHg versus 29.4±6.76 mmHg (p<0.05). Serum calcium level was lower (2.10±0.41 mmol/L versus 2.21±0.24 mmol/L; p<0.05). A direct correlation was established between RV wall thickness and proteinuria (r=0.342; p<0.05); cystatin C and the size of the right ventricle (r=0.190; p=0.002), its wall thickness (r=0.145; p=0.019), the diameter of the pulmonary artery (r=0.318; p=0.005), and the level of systolic pulmonary pressure (r=0.264; p=0.005). An inverse correlation was recorded between the estimated glomerular filtration rate (eGFR) and the size of the right ventricle (r=-0.254; p=0.005), its wall thickness (r=-0.184; p=0.003), the diameter of the pulmonary artery (r=-0.341; p=0.005), and the level of systolic pulmonary pressure (r=-0.285; p=0.005).

Conclusion. In patients with overweight and obesity, significant relationships were found between the parameters of the right ventricle and pulmonary pressure with the kidney filtration function (cystatin C, GFR).

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About the authors

Ilkhom T. Murkamilov

I.K. Akhunbaev Kyrgyz State Medical Academy named after; Salymbekov University

Author for correspondence.
Email: murkamilov.i@mail.ru
ORCID iD: 0000-0001-8513-9279

Dr.Sci. (Med.), Associate Professor at the Department of Faculty Therapy, Director of the Multidisciplinary Medical Center "Doc University Clinic"

Kyrgyzstan, Bishkek; Bishkek

Kubanych A. Aitbaev

Research Institute of Molecular Biology and Medicine

Email: aitbaev.kuban1940@gmail.com
ORCID iD: 0000-0003-4973-039X

Dr.Sci. (Med.), Professor, Head of the Department of Pathological Physiology

Kyrgyzstan, Bishkek

Viktor V. Fomin

Sechenov First Moscow State Medical University (Sechenov University)

Email: fomin_vic@mail.ru
ORCID iD: 0000-0002-2682-4417

Dr.Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Faculty Therapy No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, Vice-Rector for Innovation and Clinical Activities

Russian Federation, Moscow

Furkat A. Yusupov

Osh State University

Email: furcat_y@mail.ru
ORCID iD: 0000-0003-0632-6653

Dr.Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty

Kyrgyzstan, Osh

Tursunoy F. Yusupova

Osh State University

Email: yusupova_tursunoy_f@mail.ru
ORCID iD: 0000-0002-8502-2203

Clinical Resident of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty

Kyrgyzstan, Osh

Zulkhumor F. Yusupova

Osh State University

Email: zulkhumor.yusupova.f_05@mail.ru
ORCID iD: 0000-0001-7621-1128

4th year student at the Medical Faculty

Kyrgyzstan, Osh

Gulzat K. Duysheeva

I.K. Akhunbaev Kyrgyz State Medical Academy named after

Email: guzyu_88@mail.ru

Teaching Assistant at the Department of Faculty Therapy

Kyrgyzstan, Bishkek

Shavkat Sh. Khakimov

Salymbekov University

Email: hakimovshaki13@gmail.com
ORCID iD: 0009-0004-0437-0188

Head of the Department of Intensive Care Medicine, Therapy and Diagnostics

Kyrgyzstan, Bishkek

Islombek U. Abdurakhmanov

Saint Petersburg State University

Email: ali_islam95@mail.ru
ORCID iD: 0009-0006-0660-0113

Therapist, Researcher, City Polyclinic No.120

Russian Federation, Saint Petersburg

Zhaloliddin I. Solizhonov

Kazan State Medical University

Email: jaloliddinsolijonov44@gmail.com
ORCID iD: 0009-0003-0078-0609

6th-year student of the Faculty of Medicine

Russian Federation, Kazan

Daniyar S. Ymankulov

Medical Center "Green Clinic"

Email: ymankulov9595@mail.ru
ORCID iD: 0009-0000-4975-1196

Doctor-Researcher, Plastic Surgeon

Kyrgyzstan, Bishkek

Komil K. Khabibullaev

I.K. Akhunbaev Kyrgyz State Medical Academy named after

Email: khabibullaevkomil2001@gmail.com
ORCID iD: 0009-0004-5508-8019

6th year student of the Faculty of Medicine

Kyrgyzstan, Bishkek

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2. Fig. 1. Comparative characteristics of the concentration of serum cystatin C

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3. Fig. 2. Relationship between pancreatic thickness and proteinuria

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