ESTIMATION OF NEPHROPROTECTIVE EFFECT OF ANGIOTENSIN-CONVERTING ENZYME RAMIPRIL IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS

The aim: to examine the relations between morphological parameters of glomerular kidney damage and cystatin C (cysC) in patients with chronic glomerulonephritis (CGN) with saved renal function, and to estimate the thera-peutic correction of identified changes using ACE inhibitor ramipril.Materials and methods. The study included 81 patients with CGN. Patients were divided into 2 clinical groups: CGN patients with arterial hypertension (AH), CGN without AH. The average daily dose of ramipril in patients with AH was 12.8 ± 5.6 mg, in patients without hypertension – 2.5 mg.We used kidney biopsy data for the analysis of glomerular renal damage on the following parameters: mesangial proliferation, expansion of mesangial matrix, glomerulosclerosis, presence of fibrous crescents, thickening of capillary loops and/or their fusion with the Bowman's capsule, thickening and/or splitting of the glomerular basement membrane, extra-capillary component presence in the lumen of the Bowman's capsule. The level of cysC in serum was determined by ELISA.Results. We statistically confirmed a direct link between blood cysC and glomerulosclerosis (r = 0,85; р < 0,05). It was established that the kidney glomerulosclerosis diagnostics using cysC determination in serum is highly sensitive and specific, with an efficiency of 96.55%.Conclusion: serum level of cysC is a sensitive marker of kidney glomerulosclerosis in patients with CGN with di-agnostic efficiency up to 97%. Under the influence of 24 weeks treatment with an ACE inhibitor ramipril we observed a significant decrease in levels of kidney damage markers, which confirmed nephroprotective effect of the drug.