EFFECT OF COMBINATION THERAPY WITHFOSINOPRIL AND MELDONIUM ON THE INDICES OF 48-HOUR MONITORING OF BLOOD PRESSURE AND MYOCARDIUM GEOMETRY IN HEMODIALYSIS PATIENTS WITH CHRONIC HEART FAILURE

Despite medical advances, cardiovascular complications continue to dominate in patients treated with hemodialysis. Therefore, the search for new methods of diagnosis and treatment is advisable. The objective of our research was to study the effectiveness of combination therapy with Fosinopril and Meldonium in patients with stage У chronic kidney disease (CKD) with the signs of chronic heart failure. Materials and methods of the research: 60 patients with stage У CKD were examined and treated. They were on out-patient treatment with program hemodialysis at the Department of extracorporal methods ofdetoxification and chronic dialysis. Results. Significant decrease in left ventricular mass (LVM) by 17.20% (p<0.001) and LVM index by 13.40% (p<0.001) was detected in patients treated with combination of Fosinopril and Meldonium Dehydrate in addition to background therapy. Regression of both concentric and eccentric left ventricular hypertrophy equally occurred under the influence of combination therapy constituting 53.6% vs. 40.2% and 33.4% vs. 26.6%, respectively. The variability of systolic blood pressure (SBP) was found to decrease significantly by 36.02% (p<0.001). The survival analysis provided an opportunity to determine a reliable difference between the group treated with background therapy and the addition ofa combination of two drugs. Conclusions. The addition of Fosinopril and Mel- donium to the background dialysis therapy significantly improved the structural and geometric cardiac indices, positively affected the variability of SBP, increased the prognosis of cumulative survival compared to the background therapy.