IMPAIRMENT OF THE RENAL FUNCTION AND ITS CORRECTION WITH PERINDOPRIL IN ISCHEMIC HEART DISEASE PATIENTS WITH HEART FAILURE

Abstract

THE AIM of the work was to study renal hemodynamics and natriuresis in ischemic heart disease patients with the I and Il functional class (I FC and Il FC) heart failure against the background of treatment with one of inhibitors of angiotensin converting enzyme (IACE) - Perindopril (Prestarium). PATIENTS AND METHODS. The investigation of 60 patients (average age 58.75±1.75) included 20 patients with I FC heartfailure (first group), 20 patients with Il FC heartfailure (second group) and 20 patients without heart failure (control group). Patients of the first and second groups were given Perindopril (4 mg/daily) during 6 months against the background of basis therapy and were examined twice before and after treatment with Perindopril. Patients of the control group were examined once against the background of basis therapy. The indices of renal hemodynamics such as effective renal plasma flow (ERPF), effective renal blood flow (ERBF) and renal vascular resistance (RVR) were estimated by Hippuran 1-131 clearance. Sodium reabsorption in proximal portions of the renal tubules was determined by exogenous lithium clearance (Cl Li). RESULTS. ERPF and ERBF were reliably lower in patients of the 1 sland 2 nd groups before taking Perindopril, and RVR was reliably higher than in the control group. Indices of Cl Li in these patients were reliably lower than in the control group patients, natriuresis being somewhat lower. CONCLUSION. After 6 months of taking Perindopril ERPF and ERBF were higher and RVR lower (reliably at Il FC HF), Cl Li reliably elevated as well as natriuresis and diuresis that suggests improvement of the renal hemodynamics of the eliminating function of the kidneys.