PROGNOSTIC SIGNIFICANCE OF SOME MARKERS OF ENDOTHELIAL DYSFUNCTION IN THE DEVELOPMENT OF CHRONIC KIDNEY PATHOLOGY IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Currently, accumulated a large amount of data on the role of inflammation in the vascular endothelium damage during the development of the chronic forms of many diseases. THE AIM:  identification of endothelial dysfunction (ED) biomarkers as early  predictors of CKD development in patients with chronic lung  diseases. PATIENTS AND METHODS. 123 patients with COPD aged 55-79 years were examined, studied features of clinical and anthropometric parameters, data of the main biochemical systemic  inflammation markers and vascular endothelial dysfunction, their  significance in the development of chronic kidney disease (CKD).  RESULTS. For the first time CKD was diagnosed in 51.2% of patients  with COPD. In comorbid patients with COPD and related CKD noted  more severe course of disease. Also in these patients detected  significantly elevated endothelial dysfunction indices. CRP and  fibrinogen levels were higher in all patients with COPD and authentically correlated with disease severety. Direct correlation  between CRP and TNF-α levels was revealed. Noted that tumor  necrosis factor was higher in smoker patients with COPD. Markers of  kidneys endothelial dysfunction – homocysteine, IL-6, IL-8 – were  significantly higher in patients with decreased GFR. Also in these  patients were detected increased levels of serum creatinine and  urea. Creatinine clearance inversely correlated with homocysteine  plasma level. In all cases of fibrinogen increase in patients with  COPD. Homocysteine level was also increased, but in combination  with CKD it was significantly higher: respectively 19,8±7,51 and  39,8 ± 7,14 μmol/L, p<0,005. CONCLUSION. The received  information confirms the hypothesis about the relationship of ED  biomarkers homocysteine, TNF-α, IL-6, IL-8 with the development of chronic kidney disease in comorbid patients with COPD.