RISK FACTORS OF THE DEVELOPMENT OF CHRONIC HEART FAILURE IN PATIENTS WITH DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE

Abstract

THE AIM of the investigation was to study risk factors of the development of chronic heart failure (CH F) in patients with different stages of chronic kidney disease (CKD). PATIENTS AND METHODS. The examined 154 patients were divided into three groups depending on the stage of CKD: I. - 52 patients with a moderate stage; II - 52 patients with a medium stage; III - 46 patients with a severe stage. In all patients the determination of the levels of total serum cholecterol, TG, LPHD Cs, LPLD Cs, LPVLD Cs, K-atherogenicity, products of lipid peroxidation and antioxidant system, levels of NO was made, the structural-functional state of the LV myocardium was also studied by the finding of EchoKG. RESULTS. A multifactor regression analysis has revealed in the first group patients an independent effect of SAP and DAP on indices E(p=0.025), A (p=0.032),E/A(p=0.018)(R² = 0.23; 0.33; 0.28 respectively), and NO on E(p=0.001), E/A(p=0.02)(R²=0.23; 0.28). In the II group patients the hemoglobin level was an independent factor of changes of E (p=0.02) and E/A (p=0.001), and the level of the total NO became an independent factor of the influence on E/A (p=0.02) and NO₃ on the output fraction (p=0.002). In the III group patients - the hemoglobin level was an independent factor of the influence on E (p=0.020), A (p=0.002), E/A (p=0.006). The level of albumin on E (p=0.01), and GFR on A (p=0.001). SAP exerted a reliable influence on the output fraction (p=0.001). CONCLUSION. In aggravation of the stage of CKD the "non-traditional" risk factors of CHF become more significant in the development of myocardial dysfunction.