nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2007-11-2-55-58nefr-820Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSВЛИЯНИЕ ТЕРАПИИ СПИРОНОЛАКТОНОМ НА УРОВЕНЬ АЛЬДОСТЕРОНА И ДИСФУНКЦИЮ ЭНДОТЕЛИЯ У БОЛЬНЫХ НА ПРОГРАММНОМ ГЕМОДИАЛИЗЕTHE INFLUENCE OF SPIRONOLACTONE THERAPY ON THE LEVEL OF ALDOSTERONE AND DYSFUNCTION OF THE ENDOTHELIUM IN PROGRAMMED HEMODIALYSIS PATIENTSКарабаеваА. Ж.KarabaevaA. Zh.

кафедра нефрологии и диализа факультета последипломного обучения

ЕсаянА. М.EssaianA. M.

кафедра нефрологии и диализа факультета последипломного обучения

КаюковИ. Г.KayukovI. G.

кафедра нефрологии и диализа факультета последипломного обучения

ТимофеевМ. М.TimofeevM. M.

кафедра нефрологии и диализа факультета последипломного обучения

ВолковаО. В.VolkovaO. V.

кафедра нефрологии и диализа факультета последипломного обучения

ХристенкоА. Д.KhristenkoA. D.

кафедра нефрологии и диализа факультета последипломного обучения

Санкт-Петербургский государственный медицинский уни­верситет им. акад. И.П. Павлова; городская клиническая больница № 15, Санкт-ПетербургРоссия2007100220071125558Copyright © Карабаева А.Ж., Есаян А.М., Каюков И.Г., Тимофеев М.М., Волкова О.В., Христенко А.Д., 20072007Карабаева А.Ж., Есаян А.М., Каюков И.Г., Тимофеев М.М., Волкова О.В., Христенко А.Д.Karabaeva A.Z., Essaian A.M., Kayukov I.G., Timofeev M.M., Volkova O.V., Khristenko A.D.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/820

ЦЕЛЬ ИССЛЕДОВАНИЯ: оценить влияние терапии спиронолактоном на уровень альдостерона крови и состояние функции эндотелия у больных с хронической болезнью почек (ХБП) V стадии на программном гемодиализе. ПАЦИЕНТЫ И МЕТОДЫ. Обследовано 83 пациента с ХБП V стадии на программном гемодиализе. Проведено определение уровня альдостерона в плазме крови, оценка функционального состояния эндотелия с помощью биохимических маркеров – ингибитора активатора плазминогена 1 типа (PAI-1), тканевого активатора плазминогена (t-PA), эндотелина-1 до и после 6-месячного курса терапии спиронолактоном. РЕЗУЛЬТАТЫ. У всех больных исходно имелось значительное повышение уровня альдостерона плазмы крови – 478±99,96 пг/мл (норма - до 160 пг/мл). На фоне терапии спиронолактоном отмечено достоверное снижение уровня альдостерона до 346,45±58,1 пг/мл (р=0,009), достоверное снижение активности маркеров эндотелиальной дисфункции: эндотелина-1 с 0,63±0,09 фмоль/мл до 0,23±0,03 (р=0,002), PAI-1 с 5,69±0,24 до 3,06±0,25 U/мл (р<0,001); повышение уровня t-PA с 5,03±0,3 до 5,64±0,3 нг/мл. ЗАКЛЮЧЕНИЕ: терапия спиронолактоном у больных на программном гемодиализе приводит к снижению уровня альдостерона крови и улучшению состояния эндотелиальной функции.

THE AIM of the investigation was to assess the influence of spironolactone therapy on the level of blood aldosterone and state of the epithelium functioning in program hemodialysis patients with V stage chronic kidney disease (CKD). PATIENTS AND METHODS. In examination of 83 program hemodialysis patients with V stage CKD the following parameters were studied: the level of blood plasma aldosterone, the functional state of the epithelium assessed using biochemical markers - 1 type plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (t-PA), endothelin-1 before and after a 6-month course of spironolactone therapy. RESULTS. All the patients initially had a considerably elevated level of blood aldosterone - 478±99.96 pg/ml (norm – up to 160pg/ml). Against the background of spironolactone therapy a considerably decreased level of aldosterone to 346.45±58.1 pg/ml (p=0.009) was noted and a considerably decreased activity of the endothelium dysfunction markers: endothelin-1 from 0.63±0.09 fmol/ml to 0.23±0.03 (p=0.002), PAI-1 from 5.69±0.24 to 3.06±0.25 U/ml (p<0.001); elevated level of t-PA from 5.03±0.3 to 5.64±0.3 ng/ml. CONCLUSION.The spironolactone therapy in program hemodialysis patients results in lower level of aldosterone in blood and better state of the endothelial function.

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The authors declare that there are no conflicts of interest present.