The role of obesity in renal damage in patients with chronic heart failure

Стаценко, М. Е.; Fabritskaya, S. V.; Ryndina, Yu.A.

doi:10.36485/1561-6274-2020-24-5-29-36

Cited by 3 publications

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References 19 publications

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“…Кроме того, поражению сосудов почек могут способствовать характерные для НАЖБП активация РААС, увеличение содержания провоспалительных цитокинов, активных форм кислорода, протромботических и прокоагулянтных факторов [4]. Указанные патогенетические механизмы вызывают спазм артериол клубочков, нарушение почечного кровотока и микроциркуляции, гипоксические изменения и снижение фильтрационной способности почек [25].…”

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The effect of non-alcoholic fatty liver disease on the functional state of the kidneys in patients with chronic heart failure

Стаценко

Туркина

Fabritskaya

et al. 2021

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Aim: to study the functional state of the kidneys in patients with chronic heart failure (CHF) and non-alcoholic fatty liver disease (NAFLD).Materials and methods. 144 patients with CHF aged 45-70 years were divided into two groups: group 1 — persons with CHF and NAFLD, group 2 — CHF without NAFLD. A clinical examination was performed, the indices of FLI steatosis and NFS liver fibrosis were calculated, the functional state of the kidneys and the adipokine status were evaluated.Results. The main group of patients with CHF and NAFLD is mainly represented by people with grade I obesity (73 (84%) vs 5 (9%), p<0.05). Among patients with CHF and NAFLD, a clinically significant decrease in GFR<60 ml/min/1.73 m2 was significantly more often detected compared to patients with CHF without NAFLD (37% vs 21% in groups 1 and 2, respectively). The level of albuminuria was significantly higher in the group of patients with CHF and NAFLD (200.7±22.3 [54.7;390] vs 92.6±23.4 [10.2;188.7] mg/g in groups 1 and 2, respectively). The percentage of individuals with an AU/CR. urine ratio >30 mg/g was statistically significantly higher in group 1 compared to group 2 (82.1 vs 51.1% in groups 1 and 2, respectively). The level of serum leptin was significantly higher and the concentration of serum adiponectin was significantly lower compared to group 2 in the main group of patients with CHF and NAFLD compared to the control group. There was a significantly higher occurrence of insulin resistance in patients with CHF and NAFLD. Correlation analysis revealed the presence of statistically significant associations between the parameters characterizing the functional state of the kidneys and the indices of FLI, NFD, adipokines, and the severity of insulin resistance.Conclusion. In patients with CHF and NAFLD, a significant deterioration in the functional state of the kidneys was found, in comparison with patients with “isolated” CHF with comparable FC.

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The effect of non-alcoholic fatty liver disease on the functional state of the kidneys in patients with chronic heart failure

Стаценко

Туркина

Fabritskaya

et al. 2021

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Albuminuria as a marker of systemic congestion and a predictor of poor long-term prognosis in acute decompensated heart failure

Kobalava,

Kontareva,

Khruleva

et al. 2024

Russ J Cardiol

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Aim. To identify the relationship of different albuminuria levels with paraclinical signs of congestion on admission and discharge and with the prognosis of acute decompensated heart failure (ADHF).Material and methods. Patients hospitalized with ADHF were included. Albuminuria level was assessed on admission and discharge. Patients were divided into groups according to albuminuria level (A1, A2, A3) according to KDIGO guidelines. Among the congestion parameters, the following were assessed: N-terminal pro-brain natriuretic peptide (NT-proBNP), lung ultrasound examination (BLUE protocol), venous congestion according to the VExUS ultrasound protocol (inferior vena cava, portal, hepatic and renal veins). The primary endpoint was a composite of all-cause death and rehospitalization for ADHF within 180 days of discharge.Results. The final analysis included 180 patients. The prevalence of A1, A2 and A3 albuminuria at admission was 50%, 39%, 11%, respectively. A greater degree of albuminuria was associated with worse renal function at admission and discharge. Patients with increased albuminuria on admission had higher NT-proBNP and a greater number of B-lines on pulmonary ultrasound in on admission and discharge, and a higher degree of complex venous congestion and renal vein congestion on VExUS on admission. A3 albuminuria at admission and discharge was associated with an increased risk of poor long-term prognosis (hazard ratio (HR) 3,551; 95% confidence interval (CI) 1,593-7,914; p=0,002), (HR 4,362; 95% CI 1,623-11,726; p=0,004).Conclusion. In patients with ADHF, the albuminuria level on admission is associated with the severity of congestion upon admission and discharge. A3 albuminuria at admission and at discharge is a predictor of long-term poor prognosis within 180 days after discharge.

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Influence of viscersal obesity and adipokin status on the rsenal function in hyperstensive patients with obesity and chrsonic hearst failurse

Стаценко

Derevyanchenko

Fabritskaya

et al. 2021

Nefrologiâ (St.-Peterbg.)

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THE AIM: to evaluate the effect of visceral obesity, adipokine status on the functional state of the kidneys in patients with arterial hypertension (AH), obesity, and chronic heart failure (CHF).PATIENTS AND METHODS. 383 AH patients aged 45-70 years were divided into four groups: group 1 - persons with AH without obesity and CHF, group 2 - AH + obesity without CHF, group 3 - AH + obesity + CHF, group 4 - AH + CHF without obesity. A clinical examination was carried out, the indicators of visceral obesity, adipokine status, and functional state of the kidneys were assessed. In addition to descriptive statistics, comparison of groups with each other, and correlation analysis, multivariate regression analysis was used with the construction of regression equations.RESULTS. Revealed statistically significant differences between 1 and 2, 1 and 3, 2 and 4, 3 and 4 groups not only in body mass index (BMI) - 23.9 [22.4; 24.3] vs 32.8 [31.1; 36.3], 23.9 [22.4; 24.3] vs 33.6 [30.8; 35.6], 32.8 [31.1; 36.3] vs 24.1 [23.1; 24.5], 33.6 [30.8; 35.6] vs 24.1 [23.1; 24.5] kg / m2, respectively, but also by the percentage of visceral fat (7.0 [6.0; 8.0] vs 14.0 [11.0; 16.0] vs 18.0 [14.3; 22.0] vs 8.0 [5.0; 10.0] % in groups 1,2, 3 and 4, respectively - p1-2, p1-3, p2-3, p2-4, p3-4 less than 0,0001, p1-4 = 0.022. The level of leptin in blood serum was significantly lower in group 1 in comparison with 2, 3, 4, and in group 4 in comparison with 3 (6.9 [6.6; 22.7] vs 64.8 [59.3; 70.3], 63.6 [42.0; 86.1], 58.7 [18.9; 73.5] and 58.7 [18.9; 73, 5] vs 63.6 [42.0; 86.1] ng / ml, respectively) The serum adiponectin concentration was statistically significantly higher in group 1 compared with group 2, 3 and in group 4 compared with group 3 (36.6 [29.2; 44.1] vs 18.9 [17.1; 20.6] vs 26.9 [22.2; 32.2] and 36.8 [20.2; 62.8] vs 26,9 [22.2; 32.2] ng / ml, respectively) Visceral obesity index (VAI) was 1.49 [1.24; 2.07] vs 2.58 [2.03; 3.37] vs 3.08 [2.59; 3.84] vs 2.36 [1.81; 3.13] c.u. in groups 1,2, 3, 4, respectively, p1-2 = 0.0007, p1 -4 = 0.0001, p2-3 = 0.017, p1-3 and p3-4 less than 0.00001. There was a significant decrease in the glomerular filtration rate (GFR) in groups 3 and 4 in comparison with group 1 (59.0 [53.0; 67.8] and 69.0 [62.0; 83.0] vs 75.0 [68.0; 96.0] ml / min / 1.73 m2, respectively), as well as in group 3 in comparison with 2 and 4 (59.0 [53.0; 67.8] vs 71.0 [60.0; 86, 5] and 69.0 [62.0; 83.0] ml / min / 1.73 m2, respectively). The level of albuminuria increased with adherence to hypertension of obesity and / or CHF (14.2 [3.7; 44.4] vs 36.9 [13.6; 118.2] vs 149.8 [92.2; 247, 6] vs 72.0 [36.2; 104.7] mg / g in groups 1,2, 3 and 4, respectively, the differences are statistically significant between 1 and 2, 1 and 3, 1 and 4, 2 and 3, 3 and 4 groups). The concentration of p2-microglobulins in urine was significantly lower in group 1 compared with groups 3 and 4 (0.10 [0.05; 0.42] vs 0.25 [0.20; 0.31] vs 0.27 [0,19; 0.31] pg / ml). Correlation analysis revealed the peculiarities of the influence of visceral obesity, adipokine status on the functional state of the kidneys in each of the studied groups.CONCLUSION. The study confirmed the negative effect of visceral obesity, hyperleptinemia, and hypoadiponectinemia on the progressive deterioration of the renal function in hypertensive patients with adherence to obesity and/or CHF.

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The role of obesity in renal damage in patients with chronic heart failure

Cited by 3 publications

References 19 publications

The effect of non-alcoholic fatty liver disease on the functional state of the kidneys in patients with chronic heart failure

The effect of non-alcoholic fatty liver disease on the functional state of the kidneys in patients with chronic heart failure

Albuminuria as a marker of systemic congestion and a predictor of poor long-term prognosis in acute decompensated heart failure

Influence of viscersal obesity and adipokin status on the rsenal function in hyperstensive patients with obesity and chrsonic hearst failurse

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