THE EFFICACY EVALUATION OF THE NEPHROPROTECTIVE THERAPY: MINIREVIEW AND SAINT PETERSBURG REGISTRY DATA
https://doi.org/10.24884/1561-6274-2018-22-1-58-68
Abstract
The prevalence of end stage renal failure in the world tends to increase, creating a significant additional burden on the healthcare system. This is particularly relevant for countries with average and low gross national income relative to population. The article considers the basic directions and costs of nephroprotective therapy. The main components are to intensify antihypertensive treatment, dual blockade of the renin-angiotensin system, control of hyperlipidemia with statins, correction of anemia and deficiency of vitamin D, nutrition support, smoking cessation, restriction of salt consumption and modification of lifestyle. According to the register of Saint Petersburg, the most common causes of end stage renal failure are chronic glomerulonephritis (20%), diabetes (16.7 %), hypertension (11.8 %). In 19,7% cases diagnosis is not established. Renal protection therapy helps to increase the duration of the predialysis period to 1.5-2.0 years. By considering minimum performance criteria: a decrease in systolic blood pressure by 5 mmHg and proteinuria of 0.3 g/day. Per 1 patient costs nephroprotection make 63100 rubles per year, while on dialysis treatment 933005 rubles per year.
About the Authors
A. Yu. Zemchenkov
City Nephrology center, City Mariinsky hospital; Pavlov First Saint Petersburg State Medical University; North-Western State medical university n.a. I.I. Mechnikov
Russian Federation
Russian Federation
Zemchenkov Alexander Yurievich - PhD., internal disease and nephrology department NWS Mechnicov MU; nephrology and dialysis department Pavlov First SPSMU.
191104, 56, Liteiny pr., Saint-Petersburg,+ 7(921)918-01-90A. Sh. Rumyantsev
Saint Petersburg State Medical University; Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
MD, PhD, DMedSci, Prof., Department of Faculty Therapy SPSU; Department of propedeutic of internal diseases Pavlov First SPSMU.
199106, Saint Petersburg, V.O., 21 line 8a, +7(812) 326-03-26
A. V. Smirnov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Alexey V. Smirnov - MD, PhD, DMedSci., Prof., director.
197022, St-Petersburg, L. Tolstoy st., 17, build. 54References
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Review
For citations:
Zemchenkov A.Yu., Rumyantsev A.Sh., Smirnov A.V. THE EFFICACY EVALUATION OF THE NEPHROPROTECTIVE THERAPY: MINIREVIEW AND SAINT PETERSBURG REGISTRY DATA. Nephrology (Saint-Petersburg). 2018;22(1):58-68. (In Russ.) https://doi.org/10.24884/1561-6274-2018-22-1-58-68
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