RENAL RISCS IN DETERMINATION OF BRONCHIAL ASTHMA PHENOTYPES

The aim of this investigation was to study acid - secretory renal function and acid - base balance in patients with bronchial asthma in order to optimize the diagnostics and treatment from the pposition of phenotyping. Materials and methods. In 102 patients with moderate bronchial asthma there was studied the excretion of titratable acids by titration method, excretion ofammonium by Van Slyk - Palmer's method and acid - base status of the organism in the venous blood by blood gas analyzer 348. Respiratory function was studied on computer spirograph «Microlab 330». Results. Studied patients were divided into 3 groups according to the disorders of acid - base balance and acidsecretory renal function: 62 patients had respiratory acidosis and a significant increase in the excretion of titratable acid and ammonium; in 28 patients metabolic acidosis and a moderate increase in acid - secretory renal function were ascertained; in 12 patients respiratory alkalosis was found, acid - secretory renal function did not differ significantly from that of healthy persons. The most pronounced bronchial obstruction and bronchial hyperreactivity were observed in patients with respiratory alkalosis. The intravenous infusion of buffered 4.2% solution of sodium hydrocarbonate was included in complex therapy in 14patients with metabolic acidosis. After this treatment marked improvement of bronchial obstruction was established, as well as normalization of BE, pCO,, pO,, increased blood pH, improve control over asthma. The possibility to separate asthma phenotypes (subphenotypes) according to the disorders of the acid - base balance and acid - secretory renal function is discussed. Conclusions. Monitoring of acid - base status and acid - secretory renal function can be used in patients with asthma to separate phenotypes (subphenotypes) for disease diagnostics and treatment optimization.