Renal dysfunction in patients with chronic toxic hepatitis and ways of its correction
DOI:
https://doi.org/10.12775/JEHS.2023.13.05.023Keywords
chronic hepatitis, renal dysfunction, kidney, angiotensin-converting enzyme inhibitorAbstract
The aim of the study was to study the effectiveness of the long-acting angiotensin-converting enzyme (ACE) inhibitor Lisinopril in the correction of renal dysfunction in patients with chronic hepatitis (CH).It was found that in patients with СH under conditions of spontaneous diuresis, the glomerular filtration rate (GFR) decreases by 1.33 times against the background of a decrease in water reabsorption (p<0.05) and a tendency to a decrease in sodium excretion. During a 2-hour water load, a 3-fold decrease in GFR (p<0.05) was revealed with a slight decrease in water reabsorption and a decrease in sodium and potassium excretion in the urine (p<0.05). The occurrence of such disturbances in response to exercise indicates functional changes that may be due to intrarenal vasospasm as a result of activation of the interstitial renin-angiotensin system. The іnclusion of Lisinopril at a dose of 2.5 mg in the treatment regimen had a positive effect both on the clinical symptoms of hepatitis - a decrease in the activity of ALT, AST, urea (p<0.05), and on the functional state of the kidneys, mainly due to the effect on filtration processes. This is especially clearly demonstrated by the implementation of the water load: an increase in diuresis by 2 times (p<0.05) against the background of an increase in the glomerular filtration rate by 3 times (p<0.05), excretion of sodium and potassium (p<0.05). This indicates an increase in the adaptive function of the kidneys when included in the treatment ACE inhibitor.
References
Hartleb M, Gutkowski K. Kidneys in chronic liver diseases. World J Gastroenterol. 2012;18(24):3035-49. doi: 10.3748/wjg.v18.i24.3035
Krones E, Wagner M, Eller K, Rosenkranz AR, Trauner M, Fickert P. Bile Acid-Induced Cholemic Nephropathy. Dig Dis. 2015;33(3):367-75. doi: 10.1159/000371689
Fabrizi F, Donato FM, Messa P. Association Between Hepatitis B Virus and Chronic Kidney Disease: a Systematic Review and Meta-analysis. Ann Hepatol. 2017;16(1):21-47. doi: 10.5604/16652681.1226813
Kvasnytskaya OB, Gozhenko AI. Rol' renal'noi dysfunktsii v rozvytku porushen' vodno-elektrolitnoho balansu u khvorykh na khronichnyi hepatyt [The role of the renal dysfunction in development of breach of water-electrolitic balance in patients with chronic hepatites]. Actual problems of transport medicine. 2007;3:94-8. (in Ukranian)
Angeli P, Garcia-Tsao G, Nadim MK, Parikh CR. News in pathophysiology, definition and classification of hepatorenal syndrome: A step beyond the International Club of Ascites (ICA) consensus document. J Hepatol. 2019;71(4):811-22. doi: 10.1016/j.jhep.2019.07.002
Amin AA, Alabsawy EI, Jalan R, Davenport A. Epidemiology, pathophysiology, and management of hepatorenal syndrome. Semin Nephrol. 2019;39(1):17-30. doi: 10.1016/j.semnephrol.2018.10.002
AlQudah M, Hale TM, Czubryt MP. Targeting the renin-angiotensin-aldosterone system in fibrosis. Matrix Biology. 2020;91-92:92-108. doi: 10.1016/j.matbio.2020.04.005
Shim KY, Eom YW, Kim MY, Kang SH, Baik SK. Role of the renin-angiotensin system in hepatic fibrosis and portal hypertension. Korean J Intern Med. 2018;33(3):453-61. doi: 10.3904/kjim.2017.317
Vanhove T, Goldschmeding R, Kuypers D. Kidney Fibrosis: Origins and Interventions. Transplantation. 2017;101(4):713-26. doi: 10.1097/TP.0000000000001608.
Bazylevych AYa. Vybir antyhipertenzyvnoi terapii u khvorykh na arterial'nu hipertenziiu u poiednanni z ishemichnoiu khvoroboiu sertsia ta nealkohol'nym steatohepatytom [The choice of antihypertensive therapy in patients with hypertension in combination with ischemic heart disease and nonalcoholic steatohepatitis]. Medicine of Ukraine Plus. 2015;3:69-73. (in Ukranian)
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