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Background Chronical kidney disease (CKD) is the polymorbidity condition characterized by progressive renal function loss. Large NHANES (National Health and Nutrition examination Survey) registry data suggest an prevalence of kidney disease in adult population to be 13% with only the quarter of patients with depressed glomerular filtration rate (GFR) has been informed if they have CKD. Renal involvement in SSc occurs in the form of acute and chronic nephropathy. The feature of nephropathy in SSc is olygosymptomatic disease course. Nephropathy clinical signs manifest only on latest stages then renal processes become irreversible. Using simple diagnostic technique (GFR measurement) nephropathy debute revelation and clinical outcome exert should be possible. Objectives To study the prevalence of CKD in patients with systemic scleroderma. Methods Retrospective study of glomerular filtration rate by the MDRD (Modification of Diet in Renal Disease Study) formula in 87 patients with systemic scleroderma (7 male and 80 female, mean age 48.72±7.78 years) without previously diagnostic kidney disease, without coronary artery disease, no smoking. Results GFR ≥ 90 ml/min (1 group) revealed in 19 (22 %) persons, GFR 60- 89 ml/min (2 group) – 52 (59,7%) persons, GFR <60 ml/min (3 group) – 16 (18,3%) persons. Arterial hypertension (blood pressure >140/90 mm Hg) was noted in 31 (36%) patients. Frequency of Arterial hypertension in 3 groups of patients was the same. Changes in urinalysis, typical for tubulointerstitial lesion (specific density loss, microhematuria, moderate proteinuria) were found in 16 patients of 1 group, in 25 patients in 2 group and in 16 patients in 3 one, thus CKD of 2 and 3 stages accordingly should be predicated in this patients. We noted correlations between GFR and age (r=-0.32, p<0.05), presence respiratory symptoms (cough) (R=-0.42, p<0.05). Also we noted correlations between stage of CKD and VC (R=-0.43, p<0.001), FEV1/VC (R=0.35, p<0.01), CRP (R=0.25, p<0.05). We noted interrelations between renal disturbance and pulmonary hypertension: systolic pulmonary pressure and GFR (R=-0.21, p<0.05), CKD stage (R=0.25, p<0.05), right ventricular end-diastolic diameter and creatinine (R=0.27, p<0.01), GFR (R=-0.31, p<0.01). Also we noted correlations between total cholesterol and GFR (R=-0.63, p<0.05), CKD stage (R=0.75, p<0.05). We didn`t noted significantly correlations between arterial hypertension and creatinine, GFR, CKD stage. But we noted correlations between GFR and systolic BP (R=-0.54, p<0.05), central BP (R=-0.55, p<0.05). Conclusions Thus, 57 patients (65.5%) with systemic scleroderma had chronic kidney disease. Attention is drawn to the correlation of renal dysfunction with involvement of other organs (restrictive disorders of lung function, pulmonary hypertension), disease activity (CRP). The study suggested high renal involvement prevalence that is an unfavorable prognosis for SSc. Therefore the creatinine measurement necessity in SSc patients is clearly evident. Renoproprotective theraphy di...

Background Even the earliest subclinical renal dysfunction is an important independent risk factor for cardiovascular disease [1]. It is cardiovascular complications associated with atherosclerotic vascular disease that are the leading causes of premature mortality in rheumatoid arthritis (RA) [2]. Objectives To determine the urinary excretions of albumin in patients with RA, to identify the relationship of this indicator with risk factors for cardiovascular disease. Methods The study included 73 patients with RA at the age 18 to 60 years, who were treated at the rheumatology department of the regional hospital. Exclusion criteria were an associated kidney diseases, hypertension stage III, any kind of secondary nephropathy and pregnancy. We investigated the urinary excretions of albumin (Al) by immunoturbidimetric method in a morning urine sample. The urinary albumin excretion was considered normal for the index of Al/urine creatinine less than 17 mg/g in men and 25 mg/g in women. The arterial stiffness was detected using a Tensioclinic arteriograph (Tensiomed, Hungary). The pulse wave velocity in the aortaand augmentation index were measured. The ultrasound measuring of the carotid intima-media thickness was performed to study subclinical atherosclerosis. Results The urinary excretion of Al in the patients with RA was significantly higher than in control subjects matched for age, body mass index, blood pressure (50.27 [23.2, 100.82] mg/g and 23.43 [17.92, 30.42] mg/g, respectively, p<0.001). Increased urinary albumin excretion was found in 52 (71%) patients. The correlation was found of the urinary excretion of Al with age (r = 0.266; p = 0.023), the multiplicity of nonsteroid anti-inflammatory drugs (NSAIDs) in the month prior to the study (r = 0.271; p = 0.027), glomerular filtration rate, which was calculated by using the Modification of Diet in Renal Disease (r = -0.282; p = 0.016), low density lipoprotein (r= 0.367; p = 0.005), atherogenic index (r = 0.415; p = 0.001), pulse wave velocity in the aorta (r = 0.258; p = 0.039), augmentation index in the aorta and brachial artery (r = 0.346; p = 0.005), the carotid intima-media thickness (r = 0.270; p = 0.021). Conclusions The urinary excretion of Al in the patients with RA is significantly higher than in the control group. Increased urinary albumin excretion correlates with risk factors for cardiovascular disease (hypertension, dyslipidemia, the arterial stiffness) and with the features of the development of the RA (multiple NSAIDs). References Astor B.C., Hallan S.I.Miller E.R. et al. Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population. American Journal of Epidemiology2008;167:1226-1233 CaplanM. J. Cardiovasculardiseaseinrheumatoidarthritis. Curr. Opin. Rheumatol., 2006;18:289-97. Disclosure of Interest None Declared