DIAGNOSIS OF EARLY SIGNS OF RENAL BLOOD FLOW INSUFFICIENCY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Aim. To study the state of renal hemodynamics in patients with chronic obstructive pulmonary disease (COPD), to analyze the indicators and to propose a more simple in practical application method for diagnosing renal blood flow insufficiency in patients with COPD using the regression equation. Materials and methods. The study included 75 patients with COPD. The main clinical and biochemical parameters, respiratory function, and electrocardiography were studied, the gas composition of arterialized blood was determined; fiber bronchoscopy and chest X-ray, Doppler echocardiography and duplex scanning of renal arteries were performed. The state of renal excretory function was determined by glomerular filtration rate and creatinine clearance. Results. A new method for diagnosing renal blood  flow insufficiency in patients with COPD is presented. The essence of the method is to determine the end-systolic volume of the right ventricle according to Doppler echocardiography, smoking history, left ventricular ejection fraction, urea and creatinine in the blood and solution of the regression equation. The numerical value of the equation in 65 and more points allows diagnosing the presence of signs of renal blood flow insufficiency, if it is less than 65 points there are no signs. Previously, 75 patients with COPD were correlated using the following variables: smoking history, end-systolic volume of the right ventricle, left ventricular ejection fraction, urea and creatinine levels in biochemical blood analysis. The multiple determination coefficient (R2) was 0.80 (80.0%), which confirms the reliability of the model forecast. Conclusion. This method can be used to diagnose early signs of renal blood flow insufficiency in COPD patients with the aim of a differentiated approach to the choice of treatment and prevention measures and improve the prognosis of the disease.