Toshev B.B. Republican Specialized Scientific and Practical Medical Center Therapy And Medical Rehabilitation, Tashkent, Uzbekistan
Title: Influence of lyzinoprile and losartan on the indicators of the functional state of kidneys in patients with chronic heart failure depending on the degree of dysfunction of kidneys
Rasulova Z.D. has completed his Ph.D. at the age of 30 years from Tashkent Medical Academy. She is the Senior Researcher of the Republican Specialized Scientific and Practical Center for Therapy and Medical Rehabilitation. He has published more than 30 papers in reputed journals.
Purpose. To study the effect of lisinopril and losartan on the functional state of the kidneys of patients with I-III functional class (FC) of chronic heart failure (CHF), depending on the degree of renal dysfunction (RD).
Research methods. A total of 223 patients with ischemic heart disease with I-III FC of CHF were examined, initially and after 6 months of treatment. The first group (I) consisted of 118 patients taking lisinopril as part of standard therapy; the second group (II) - 105 patients taking losartan. Also, all patients were divided into 2 groups depending on the estimated rate of the glomerular filtration (eGFR): 30 < eGFR ≤60 ml/min/1.73 m2 - 67 patients (29 patients in the I group, 38 - in the II group), and eGFR > 60 ml/min/1.73m2 -156 patients (89 patients in group 1, 67 patients in group 2).
Results. The nephroprotective effect of standard therapy with the inclusion of lisinopril or losartan was noted, with a significant decrease in the level of enzymes in the urine, as a sign of dysfunction of the tubular kidney apparatus, a decrease in creatinine, and an increase in GFR. In patients with CHF with a preserved RSKF>60 ml/min/1.73 m2 and moderate DP with eGFR = 59-45 ml/min/1.73 m2, the use of standard lisinopril or losartan showed reliable nephroprotection. In patients with CHF with kidney dysfunction with 30>eGFR<45 ml/min/1.73 m2, a significant improvement in renal dysfunction was observed in the group of patients taking standard therapy - losartan.
Conclusion. The results of our study showed the nephroprotective effect of the standard therapy with the inclusion - lisinopril and losartan, with a significant decrease in the level of enzymes in the urine, as a sign of dysfunction of the tubular kidney apparatus, a decrease in creatinine and an increase in GFR, a more pronounced effect was observed in patients taking losartan.