Русский
Clinical and functional characteristics of mineral and bone disorders in chronic kidney disease
DOI: https://dx.doi.org/10.18565/nephrology.2023.1.45-53
Murkamilov I.T., Fomin V.V., Murkamilova Zh.A., Sabirova A.I., Sabirov I.S., Yusupov F.A., Maanaev T.I., Zakirov O.T., Gasanov K.A.
1) I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan; 2) Kyrgyz-Russian Slavic University n.a. the First President of the Russian Federation B.N. Yeltsin, Bishkek, Kyrgyzstan; 3) Sechenov University, Moscow, Russia; 4) Osh State University, Osh, Kyrgyzstan; 5) National Hospital under the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan; 6) South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Material and methods. The study included 108 middle-aged patients with CKD (53.6±14.9 years), 66 (61.1%) men and 42 (38.9%) women. All patients with CKD underwent general clinical and biochemical examinations to determine the parameters of mineral metabolism - calcium, phosphorus, parathyroid hormone (PTH), vitamin D, alkaline phosphatase levels. The CAD levels and lipid metabolism were assessed. Estimated glomerular filtration rate (eGFR) was determined by the CKD-EPI method based on serum creatinine level. The total sample was divided into two groups: group 1 - CKD with GFR>60 ml/min/1.73 m2 (n=33); group 2 - patients CKD with GFR ≤60 ml/min/1.73 m2 (n=75), and the patients of both groups were comparable in age.
Results. In the group of patients with CKD and eGFR≤60 ml/min/1.73 m2 (n=75), the following changes were recorded: arterial hypertension and stable angina were detected significantly more often (P<0.05); the systolic and diastolic blood pressure (BP) and CAP levels were significantly higher, and the of hemoglobin (Hb) concentration and the peripheral red blood cell count were significantly lower (p<0.05). A significant decrease in the blood high-density lipoprotein cholesterol, an increase in the uric acid, fibrinogen, phosphorus and PTH levels were noted in patients with CKD complicated by renal failure. An increase in the PTH level was found to correlate with a decrease in the filtration function of the kidneys (r=-0.4988; P<0.05) and an increase in the blood serum phosphorus concentration (r=-0.5066; P<0.05). A significant negative relationship was found between the Hb and PTH concentrations (r=-0.4086; P<0.05). A direct correlation was found between the PTH level and the fibrinogen concentrations (r=0.6849; P<0.05), blood C-reactive protein (CRP) level (r=0.5905; P<0.05), as well as the CAP level (r=0.5640; P<0.05).
Conclusion. In patients with CKD, mineral and bone disorders are accompanied by a deterioration in central hemodynamic parameters, the development of a pro-inflammatory status, anemia, hyperuricemia, and dyslipidemia.
About the Autors
Ilkhom T. Murkamilov – Dr.Sci. (Med.), Associate Professor at the Department of Faculty Therapy, I.K. Akhunbayev KSMA, Associate Professor at the Department of Therapy № 2, KRSU named after B.N. Yeltsin. Address: 92 Akhunbaev st., Bishkek, 720020; tel.: (+996) 557-221-983; e-mail: murkamilov.i@mail.ru. ORCID: org/0000-0001-8513-9279.
Viktor V. Fomin – Dr. Sci. (Med.), Professor, Corresponding Member of the RAS, Head of the Department of Faculty Therapy № 1, Institute of Clinical Medicine
n.a. N.V. Sklifosovsky, Vice-Rector for Innovation and Clinical Activities, Sechenov University. Address: 2 Bolshaya Pirogovskaya st., Moscow, 119991; tel. 8 (495) 609-14-00, ext. 2142; e-mail: fomin_vic@mail.ru. ORCID: org/0000-0002-2682-4417
Zhamila A. Murkamilova – Postgraduate Student in specialty “General Medicine”, Department of Therapy № 2, KRSU named after. B.N. Yeltsin. Address: 3 T. Moldo st., Bishkek. 720040; tel. (+996) 552-435-009; e-mail: murkamilovazh.t@mail.ru. ORCID: org/0000-0002-7653-0433
Aziza I. Sabirova – Cand.Sci. (Med.), Acting Associate Professor at the Department of Surgical Dentistry, KRSU named after B.N. Yeltsin. Address: 44 Kievskaya st., Bishkek, 720022; tel. (996) 362-65-52; e-mail: azizasabirova@bk.ru. ORCID: 0000-0001-8055-6233
Ibragim S. Sabirov – Dr.Sci. (Med.), Professor, Head of the Department of Therapy № 2, Medical Faculty of the KRSU named after. B.N. Yeltsin. Address: 44 Kievskaya st., Bishkek, 720022; tel. (996) 555-816-842; e-mail: sabirov_is@mail.ru. ORCID: org/0000-0002-8387-5800
Furkat A. Yusupov – Dr. Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University, Chief Neurologist of the Southern Region of Kyrgyzstan. Address: 331 Lenin st., Osh, 714000; tel. (+996) 557-202-071; e-mail: furcat_y@mail.ru. ORCID: org/0000-0003-0632-6653
Toktobay I. Maanaev – Cand.Sci. (Med.), Chief Physician of the National Hospital under the Ministry of Health of the Kyrgyz Republic. Address: 1 T. Moldo st., Bishkek,720040; tel. (0312) 620-991. ORCID: 0000-0003-4758-4982
Omurbek T. Zakirov – Resident Medical Practitioner, Faculty of Medicine, KRSU named after. B.N. Yeltsin. Address: 44 Kievskaya st., Bishkek, 720022; e-mail: omurbekkarasuu@gmail.com
Kamranbey A. Gasanov – first-year resident physician, South Kazakhstan Medical Academy. Address: 1 Al-Farabi Square, Shymkent, 160019; e-mail: gassanov_k@mail.ru. ORCID: 0000-0003-0173-8851
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