INFLUENCE OF β¬ADRENOBLOCKERS ON MARKERS OF PROGRESSING CHRONIC GLOMERULONEPHRITIS IN HYPERTENSIVE PATIENTS WITH SAVED AND REDUCED FUNCTION OF THE KIDNEYS

THE AIM of the investigation was to assess the effects of βadrenoblockers on certain clinical and laboratory markers of progressing chronic glomerulonephritis. PATIENTS AND METHODS. Under observation there were 125 hypertensive patients with chronic glomerulonephritis. The patients were divided into 2 groups: 62 (49.6%) of them were included in the first group with the saved function of the kidney and 63 (50.4%) patients with the reduced function made up the second group. The groups were divided into subgroups depending on the given βadrenoblocker. The distribution of the patients in the subgroups was fulfilled with special reference to specially developed criteria taking into account the maximal similarity of the clinical, morphological and laboratory course of the disease. Diurnal proteinuria, glomerular filtration rate, glomerular permeability index, degree of albuminuria, general peripheral vascular resistance were investigated before treatment, at discharge from hospital and within 86 months after beginning the treatment. Total cholesterol and triglycerides were determined. The diurnal index was calculated, the arterial hypertension type was determined. RESULTS. Carvedilol and Nebivolol increased the glomerular filtration rate in patients with saved function of the kidney and decreased the general peripheral vascular resistance. Carvedilol in both groups had hypolipidemic properties. Pindolol in patients with saved function of the kidneys and Nebivolol and Pindolol in patients with reduced function of the kidneys decreased the glomerular filtration rate. The necessary figures of pressure in the first group were obtained in 50% of patients treated with Metoprolol, in the second group in 25% of patients treated with Nebivolol. Metoprolol and Nebivolol in the first group caused excessively decreased nocturnal pressure. βadrenoblockers increased occurrence of favorable types of hypertension (nightpeaker and dipper) in patients with saved function of the kidney. In patients with renal failure Pindolol increased the frequency of the development of noncontrolled nocturnal hypertension (nightpeaker type). CONCLUSION. Specific properties of pharmacodynamics of the medicine should be taken into account when choosing βadrenoblocker for treatment of patients with chronic glomerulonephritis.

1. Тареева ИЕ, ред. Нефрология. Руководство для врачей. Медицина, М., 2000; 448453

2. Rosert JA, Wauters JP. Recommendations for the screening and management of patients with kidney disease. Nephrol Dial Transplant 2002; 17 [Suppl 1]: 1928

3. Ковалева ОН. Классификация, патогенез и лечение нефрогенной артериальной гипертензии. Укр тер журнал 2002; (2): 6671

4. Сиренко Ю. Особенности лечения артериальной гипертензии при поражении почек. Ліки України 2004; (10): 69

5. Таран О, Дудар А, Таран А, Валецька Р. Лікування ре нопаренхімної гіпертензії. Ліки України 2003; (3): 1114

6. 1999 WHOISH guide-lines for the man-age-ment of hy-per-ten-sion. J hypertens 1999; 11: 905916

7. Кобалава ЖД, Терещенко СН, Калинкин АЛ. Суточное мониторирование артериального давления: методические аспекты и клиническое значение. Медицина, М., 1997; 32 с.

8. Власенко МА, Ромасько НВ. Механизмы развития гло мерулосклероза при хронических гломерулонефритах. Укр тер журнал 2002; (2): 1924

9. Ruilope LM, Rodicio JL. The kidney in arterial hypertension. Nephrol Dial Transplant 2001; 16: 5052

10. Синяченко ОВ, Дьяков ИН, Игнатенко ГА. Обоснование и перспективы использования небиволола в лечении больных гломерулонефритами. Укр мед. Часопис 2001; (4): 122128

11. Кошелева ОВ, Гришкин ЮН. Амбулаторное суточное мониторирование артериального давления. Новые Санкт-Петерб врач ведомости 2002; (3): 3840