NEPHROPATHIC CHARACTERISTICS IN PATIENTS WITH DIABETES MELLITUS TYPE 2 AND ESSENTIAL HYPERTENSIVE DISEASE

In diabetes mellitus type 2 combined with essential hypertensive disease, the risk of kidney failure increases by 15-20 times. Diabetic nephropathy is the most common cause of kidney failure - about 34% of all cases. So important is early diagnosis and regular monitoring of renal function in patients with diabetes mellitus type 2 and essential hypertensive disease. Aim. To study nephropathic characteristics in patients with diabetes mellitus type 2 (DM2) combined with es-sential hypertensive disease (EHD) on the basis of blood pressure, glucose metabolism and lipid levels. Materials and methods. 75 patients were examined: 25 patients with essential hypertensive disease degree 1-2, stage II, treatment-compensated (Group I), and 25 patients with subcompensated diabetes mellitus type 2 [glycated hemoglobin (HbA1C) - from 7.0% to 11.0%] (Group II) and 25 patients with subcompensated diabetes mellitus type 2 [glycated hemoglobin (HbA1C) - from 7.0% to 11.0%] combined with essential hypertensive disease (Group III). Among the patients surveyed, there were 40 females and 35 males, the average age was (59.8 ± 5.3) years. The control group consisted of 20 healthy volunteers. Groups surveyed were randomized in age, sex, body mass index, duration of diabetes mellitus type 2 and essential hypertensive disease. Determination of glucose metabolism based on the assess-ment of glycated hemoglobin (HbA1C), blood lipid profile tests, renal function tests etc were carried out. The decrease in GFR from 89 to 60 mL / min. / 1.73 m2 was regarded as mild kidney failure or dysfunction, from 59 to 30 ml / min. / 1.73 m2 as moderate and from 29 to 15 ml / min. / 1.73 m2 as severe; for 3 months or more with or without the presence of features of nephropathy that meet the definition of chronic kidney disease (CKD). Results. In patients with DM2 combined with EHD, there is a severe impairment of kidney function with increasing microalbuminuria (MAU) and a decrease in glomerular filtration rate (GFR). Correlations between increased microalbuminuria, reduced GFR, systolic blood pressure (SBP), HbA1C, total cholesterol (TC), triglycerides (TG) and low density lipoprotein (LDL) indicate the multifactorial process of kidney damage in patients with DM2 combined with EHD and a high risk of cardiovascular diseases. Conclusion. To study nephropathic characteristics in patients with DM2 combined with EHD, it is necessary to constantly monitor MAU, GFR together with blood pressure, HbA1C and blood lipid profile.