Nursing Function Condition in Patients with Hypertonic Disease Including Different Forms of Extrasistoly

Renal impairment in arterial hypertension is considered a typical lesions variant of target organs such as: heart, blood vessels and brain. Growing interest in renal impairment in arterial hypertension may be justified given the prevalence of nephrosclerosis as a cause of renal failure, and the fact that even slight signs of renal dysfunction appear (increased creatinine, decreased creatinine clearance, the appearance of micro- and macroalbuminuria) means a significant increase in the risk of cardiovascular complications developing and cardiac death. However, despite a large number of works devoted to the study of the cardiac and renal pathology connection, a large number of issues regarding this problem still remain unexplored. One of them devoted to peculiarities of the kidneys' disorder in patients with arterial hypertension, having different types of extrasystoles. In addition, the question of more accurate markers of renal dysfunction usage, such as: microalbuminuria, uric acid and cystatin C. The purpose of the article is to determine the nature of functional condition of cardio-vascular system and kidneys' violations in patients with hypertonic disease with different variants of extrasystoles. Materials and methods: Common clinical methods, clinical observation of patients with hypertension; Instrumental methods (electrocardiography in 12 standard leads, Holter monitoring of ECG; echocardiography in M-, B- and D-modes); Laboratory and biochemical methods (creatinine, uric acid, proteinuria, microalbuminuria, glomerular filtration rate by the formula CKD-EPI); Statistical methods (methods of parametric and nonparametric statistics). Results. All patients (90 people) were divided into groups, depending on the extrasystole version. The first group included patients with hypertension and supraventricular extrasystole, the second – patients with hypertension and ventricular extrasystole. The comparison group consisted of 30 people for hypertension without cardiac rhythm disturbances. The obtained data showed that in patients with hypertension and frequent extrasystole, regardless of its variant, in comparison with patients without arrhythmias, a significant increase in the average level of uric acid is recorded. The latter fact showed that the possible predictor of arrhythmia in patients with hypertension was the level of uric acid. Attention was drawn to the fact that the most evident differences in the analyzed parameters were found in patients with a frequency of ventricular extrasystole. Thus, in this group of patients, unlike patients without arrhythmias and with the frequency of supraventricular extrasystole, there was a significant increase in the incidence of microalbuminuria cases, the overall frequency of microalbuminuria + proteinemia and the median level of uric acid and decrease in glomerular filtration rate. Conclusion. The most severe renal impairment has been observed in patients with hypertension and ventricular extrasystole than in other groups. This can be explained as early manifestations of cardiorenal disorders occurring in this category of patients. Therefore, such issues are expedient to further in-depth study of this problem: the clarification of the issues regarding the nature and pace of hypertensive nephropathy development in different categories of patients with GC, the detection and study of earlier markers of renal dysfunction, optimization of extrasystoles treatment in different categories of patients, an antiarrhythmic efficacy evaluation of different groups of antiarrhythmic drugs in patients with GC.