Peculiarities of chronic kidney disease progression in the long-term period in multifocal atherosclerosis patients


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Abstract

Chronic kidney disease (CKD) is a pathology getting a noninfectious epidemic character due to its high prevalence in the population, a sharp decrease of life quality and fact of high mortality, which dictates the necessity to optimize its prognostic instruments in patients with very high cardiovascular risk. The aim is to study the peculiarities of CKD progression and develop an algorithm for its prediction in patients with multifocal atherosclerosis. Material and methods. The study included 519 patients with atherosclerotic lesions of different vascular basins treated in profile departments. 360 (69,4%) of them were males and 159 (30,6%) - females. Average age of the examined patients was 60,0±8,7 years old. The patients underwent a complex of laboratory and a number of instrumental examinations, including (if indicated) coronary angiography, angiography of renal, brachiocephalic and lower limb arteries. During the prospective follow-up (36 months) the peculiarities of CKD progression in the presented group of patients were evaluated. Results. Data obtained by two-factor logistic regression analysis show a significant impact of such features as «GFR (CKD-EPI), ml/min/1,73m2 + nephrosclerosis», «presence of atherosclerotic lesion of posterior interventricular branch + degree of atherosclerotic stenosis of left renal artery in bilateral lesion, %» on risk of CKD development in long-term follow-up period of the study group patients. Conclusion. The performed complex analysis made it possible to develop original nomograms of CKD risk assessment in the long-term period; their use in clinical practice will contribute to the identification of risk groups and increase the preventive measures efficacy in multifocal atherosclerosis patients.

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About the authors

Natalia D. Kobzeva

Rostov State Medical University of the Ministry of Healthcare of Russia

Email: kobzeva.nataliya1@gmail.com
PhD in Medicine, associate professor of the Department of internal diseases No. 1

Anatoly I. Martynov

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Dr. med. habil., professor, academician of RAS, professor of the Department of hospital therapy No. 1

Vladimir P. Terentiev

Rostov State Medical University of the Ministry of Healthcare of Russia

Email: vpterentev@mail.ru
Dr. med. habil., professor, head of the Department of internal diseases No. 1

Mikhail M. Batyushin

Rostov State Medical University of the Ministry of Healthcare of Russia

Email: batjushin-m@rambler.ru
Dr. med. habil., professor, professor of the Department of internal diseases No. 2

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