medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-319medsovet-7813Research ArticleПРАКТИКАPRACTICEХарактеристика острого повреждения почек у пациентов с острой декомпенсацией сердечной недостаточностиCharacteristics of acute kidney injury in patients with acute decompensation of heart failurehttps://orcid.org/0000-0001-7667-910XДавыдовВ. В.DavydovV. V.

Давыдов Владимир Валентинович - доктор медицинских наук, доцент, профессор кафедры анестезиологии, реаниматологии и клинической фармакологии с курсом дополнительного профессионального образования.

656038, Барнаул, проспект Ленина, д. 40

Vladimir V. Davydov - Dr. Sci. (Med.), Associate Professor, Professor of the Department of Anesthesiology, Resuscitation and Clinical Pharmacology with the Сourse of Additional Professional Education.

40, Lenin Ave., Barnaul, 656038

6davv@mail.ruhttps://orcid.org/0000-0002-7049-5585АрехинаЕ. Л.ArehinaE. L.

Арехина Екатерина Леонидовна - заместитель главного врача по лечебной работе.

656010, Барнаул, ул. Петра Сухова, д. 13

Ekaterina L. Arechina - Deputy Chief Physician for Medical Work.

13, Petr Sukhov St., Barnaul, 656010

arehina_katerina@mail.ruАлтайский государственный медицинский университетРоссияAltai State Medical UniversityRussian FederationГородская больница № 8РоссияCity Clinical Hospital No 8Russian Federation202322102023016162170Copyright © Давыдов В.В., Арехина Е.Л., 20232023Давыдов В.В., Арехина Е.Л.Davydov V.V., Arehina E.L.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7813Введение

Введение. Острая декомпенсация сердечной недостаточности (ОДСН) нередко сопровождается острым повреждением почек (ОПП), гипонатриемией, эпизодами олигурии и полиурии в ответ на применение фуросемида в комплексной терапии заболевания. Эти осложнения удлиняют время госпитализации, увеличивают экономические затраты на лечение и ухудшают прогноз. В настоящее время не изучалась взаимосвязь этих проявлений у больных с ОДСН.

Цель

Цель. Оценить влияние ОПП на темп диуреза и уровень натриемии плазмы в ходе комплексной терапии ОДСН. Материалы и методы. Проведена оценка функции почек у 125 больных, получавших комплексную терапию ОДСН. Скорость клубочковой фильтрации (СКФ) определяли двумя способами: по уровню креатинина и цистатина С сыворотки крови. Изучалась частота ОПП, гипонатриемии, эпизодов олигурии и полиурии. Проведен анализ взаимосвязи этих событий. Результаты. На этапе поступления в стационар изучение СКФ по уровню цистатина С позволило выявить в 2,6 раза больше ОПП, чем по уровню креатинина. Всего у пациентов с ОДСН установлено ОПП в 22,4% случаев, гипонатриемия в 24,8%, эпизоды олигурии в 18,4%, эпизоды полиурии в 24,8%. Анализ показал, что существует связь нарушений темпа диуреза и гипонатриемии с ОПП.

Выводы

Выводы. ОПП по сравнению со стабильной функцией почек приводило к увеличению числа пациентов с эпизодами олигурии и полиурии в 2,9 раза и числа пациентов с гипонатриемией на завершающем этапе лечения ОДСН в 4,2 раза.

Introduction

Introduction. Acute decompensation of heart failure (AHF) can cause acute kidney injury (AKI), hyponatremia, episodes of oliguria and polyuria in the treatment of furosemide. These complications lengthen the time of hospitalization, increase the economic costs of treatment and worsen the prognosis. Currently, the relationship of these manifestations in patients with CHF has not been studied.

Objective

Objective. To evaluate the effect of AKI on the rate of diuresis and the level of plasma sodium during the complex therapy of AHF.

Materials and methods

Materials and methods. Kidney function was assessed in 125 patients receiving complex therapy for AHF. The glomerular filtration rate (GFR) was determined in two ways: by the level of creatinine and cystatin C in blood serum. The number of AKI, hyponatremia, episodes of oliguria and polyuria were studied. An analysis of the relationship between these events was carried out.

Results

Results. At the time of admission to the hospital, the study of GFR by the level of cystatin C showed 2.6 times more AKI than by the level of creatinine. In total, AKI was found in 22.4% of cases, hyponatremia in 24.8%, episodes of oliguria in 18.4%, episodes of polyuria in 24.8%. The analysis showed that there is a connection of violations of the rate of diuresis and hyponatremia with AKI.

Conclusions

Conclusions. Сases of impaired urinary excretion and hyponatremia during AHF therapy are more common in patients with AKI.

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The authors declare that there are no conflicts of interest present.