Abstract:
AIM:To study the incidence, pattern, and predictive factors of concurrent kidney and liver dysfunctions in patients with decompensated heart failure (HF). SUBJECTS AND METHODS:The kidney and liver function indicators were estimated in 322 patients aged 69.5±10.6 years with decompensated HF (hypertension in 87%, myocardial infarction in 57%, atrial fibrillation in 65%, chronic kidney disease in 39%, type 2 diabetes in 42%, a left ventricular ejection fraction (EF) of 38±13%, EF <35% 39%, NYHA Functional Class IV in 56%). Cardiohepatic syndrome (CHS) was diagnosed if at least one indicator of liver function was increased; acute kidney injury (AKI) was diagnosed using the KDIGO criteria. RESULTS:AKI and CHS had been previously diagnosed in 60 (18.6%) and 274 (85.1%) patients, respectively. Among the patients with signs of kidney and/or liver dysfunction, the incidence of isolated CHS, concurrent AKI and CHS, and isolated AKI was 78.4, 20.1, and 1.5%, respectively. The patients with concurrent kidney and liver dysfunctions were observed to have more profound systemic hemodynamic changes (hypoperfusion and congestion). The risk of concurrent AKI and CHS increased glomerular filtration rate (GFR) <45 ml/min/1.73 m2, admission systolic blood pressure <110 mm Hg, needs for vasopressors, hydropericardium, and EF <35%. The concurrence of AKI and CHS was associated with longer hospital stay (15.7±6.5 and 13.5±4.8 days, respectively; p<0.05). CONCLUSION:The incidence of concurrent AKI and CHS in patients with decompensated HF is 20.1%. Concurrent kidney and liver dysfunctions is associated with more obvious signs of hypoperfusion and congestion and characterized by worse prognosis. :Цель исследования. Изучить частоту, характер и прогностические факторы сочетанного нарушения функции почек и печени у пациентов с декомпенсацией сердечной недостаточности (СН). Материалы и методы. У 322 пациентов с декомпенсацией СН (возраст 69,5±10,6 года, артериальная гипертония у 87%, инфаркт миокарда у 57%, фибрилляция предсердий у 65%, хроническая болезнь почек у 39%, сахарный диабет 2-го типа у 42%; фракция выброса - ФВ левого желудочка <35% у 39%, NYHA IV функциональный класс у 56%) оценены показатели функции почек и печени. Сердечно-печеночный синдром (СПС) диагностировали при повышении хотя бы одного показателя функции печени, острое повреждение почек (ОПП) - по критериям KDIGO. Результаты. Раннее ОПП диагностировано у 60 (18,6%) пациентов, СПС - у 274 (85,1%). Среди пациентов с признаками нарушения функции почек и/или печени частота изолированного СПС, сочетания ОПП и СПС, изолированного ОПП составила 78,4, 20,1 и 1,5% соответственно. У пациентов с сочетанным нарушением функции почек и печени наблюдались более выраженные изменения системной гемодинамики (гипоперфузии и застоя). Риск сочетанного ОПП и СПС увеличивали СКФ <45 мл/мин/1,73 м2, систолическое артериальное давление <110 мм рт.ст. при поступлении, потребность в вазопрессорах, гидроперикард, ФВ <35%. Сочетание ОПП и СПС ассоциировалось с большей длительностью пребывания больных в стационаре (15,7±6,5 и 13,5±4,8 дня соответственно; p<0,05). Заключение. Частота сочетанного ОПП и СПС у пациентов с декомпенсированной СН составляет 20,1%. Сочетанное нарушение функции почек и печени ассоциируется с более выраженными признаками гипоперфузии, застоя и характеризуется худшим прогнозом.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Villevalde SV,Kobalava ZD,Solovyeva AЕ,Moiseev VSdoi
10.17116/terarkh201688640-44subject
Has Abstractpub_date
2016-01-01 00:00:00pages
40-44issue
6eissn
0040-3660issn
2309-5342journal_volume
88pub_type
杂志文章abstract::The amino acid composition of blood serum was studied in patients with duodenal ulcers, with this parameter characterizing protein metabolism most delicately. Essential changes were established in the amino acid composition as dependent on a number of factors: disease standing, complications and their duration, acid-f...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::A study was made of the possibilities of an individual approach to intraarticular administration of protease inhibitors, cytostatics and orgoteine in patients with rheumatoid arthritis (RA). The activity of hyaluronidase, superoxide dismutase, the level of rheumatoid factor and the phagocyte count in synovial fluid we...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::Forty patients aged 33 to 66 years suffering from chronic alcoholism, stages II-III, were examined. All the patients were subjected to contrast ventriculography before and after exercise test to identify the latent forms of heart failure. According to the coronarography findings, 9 out of the 40 patients demonstrated ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM:To study mobilisation of peripheral blood stem cells (PBSC) via single and split subcutaneous injection of granulocytic colony-stimulating factor (G-CSF) and isolation of PBSC concentrates for their transplantation with leukapheresis (LA) and large volume leukapheresis (LVL) in patients with solid tumors and hemato...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:AIM:To evaluate the impact of hyperglycemia concurrent with obstructive sleep apnea syndrome (OSAS) on endothelial function (EF) and vessel remodeling in patients with Grade 1-2 hypertension. MATERIAL AND METHODS:A total of 101 patients with Grade 1-2 hypertension were examined. A study group (SG) consisted of 74 hype...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh2015871026-30
更新日期:2015-01-01 00:00:00
abstract::The authors studied the potentialities of employment of a new method of exercise tests (cyclic bicycle ergometry) for the assessment of convalescents' function and working capacity following acute communicable diseases. The above method showed the relationship of convalescents' function and working capacity with a nos...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::In the course of chronic active hepatitis (CAH) 61 patients (CAH of virus etiology in 75% and of obscure etiology in 25%) had 211 pregnancies which terminated in delivery in 80 (38%) cases, spontaneous abortions in 12 (6%) cases, and medical abortions in 119 (56%) cases. In most cases there was successful termination ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:AIM:To study morphofunctional features of the upper airways (UAW) in wakeful patients (juveniles with arterial hypertension stage I) and genetic predisposition to UAW obstruction in sleeping patients. MATERIAL AND METHODS:The examination of 18 juveniles with arterial hypertension stage I and II normotensive juveniles ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:AIM:To investigate the effect of recombinant alpha 2b-interferon (r alpha 2b-IFN) on functional capacity of peripheral blood (PB) T cells in rheumatoid arthritis (RA) patients and the relationship between functional characteristics of T lymphocytes and the disease activity. MATERIALS AND METHODS:PB mononuclear cells (...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Osteoarthritis is a common pathology, which indicates the great medical and social significance of this disease. The article discusses the issues of pathogenesis, risk factors and diagnosis of professional and professionally caused osteoarthritis: the age of onset of the disease, the specifics of work, the localizatio...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2020.06.000620
更新日期:2020-07-09 00:00:00
abstract:UNLABELLED:To study prevalence of polyresistance (PR) among the strains of Helicobacter pylori isolated from patients with chronic gastritis, gastroduodenal ulcer and gastric cancer in Georgia. Material and methods. Biopsies of gastric mucosa and resection material were studied in 206patients with gastroduodenal zone d...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:AIM:To quantify interleukin-8 (IL-8), interleukin-2 (IL-2) and soluble receptor of IL-2 (sIL-2r) in blood serum of patients with various forms of ischemic heart disease (IHD). MATERIAL AND METHODS:Levels of IL-8, IL-2 and sIL-2r were measured with enzyme immunoassay (EIA) in the serum of 75 patients with IHD: angina o...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::After prosthetics of the aortal valve 30 patients underwent bicycle ergometry training at the sanatorial stage of rehabilitation. 10 patients who did not undergo bicycle ergometry training made up the control group. The efficacy of bicycle ergometry training was assessed according to the time-course of changes in pump...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To evaluate occurrence, variety, structural peculiarities and prognostic meaning of cytogenetic abnormalities in adult patients with Ph-negative acute lymphoblastic leukemia (ALL) receiving therapy according to ALL-2009 protocol. MATERIALS AND METHODS:The study included 115 adult patients with firstly diagnosed Ph...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/terarkh201890730-37
更新日期:2018-08-17 00:00:00
abstract::Radical radiation therapy provided complete remissions in 152 out of 166 patients with Hodgkin's disease, stages I-II-IIIs. During 3 to 17 years of observation, the relapses occurred in 67 patients (44%). A half of all the relapses were recorded during the first year of remission. In 88% of the cases the relapses were...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Overall 30 patients with multiple myeloma (MM) were examined for immunological and rheological parameters. MM was shown to be marked by imbalance of immunobiological reactivity, with the greatest changes being seen in the B cell immunity system. MM is also characterized by marked rheological shifts related to the immu...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To determine the possible boundaries of high-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation (HDIT-autoHSCT) for autoimmune diseases (AUDs), such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and multiple sclerosis (MS). SUBJECTS AND METHODS:A long-term tri...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201688153-59
更新日期:2016-01-01 00:00:00
abstract:AIM:To study effects of two hypotensive drugs--normodipin and spirapril--on intravascular activity of platelets in patients with metabolic syndrome (MS). MATERIAL AND METHODS:Normodipin was given to 25 patients with MS for 3 months, spirapril--to 20 patients for 3 months. The effect was evaluated by changes in lipid p...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:AIM:To characterize coronary arteries and myocardial perfusion in isolated ischemic heart disease (IHD) and IHD combined with blood hypertension (BH). MATERIALS AND METHODS:20 patients with isolated IHD and 25 patients with combined IHD have undergone coronarography, scintigraphy of the myocardium with Tc-99m, echocar...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Short-term results of rehabilitation of 1046 CHD patients at a cardiological sanatorium in mountains at average altitude (1600 m above the sea level) were studied. Large focal myocardial infarction (MI) was found in 738 of them, small focal MI in 249, and acute focal myocardial dystrophy of ischemic genesis in 59. Of ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::The given review considers the pathogenesis, diagnosis, and clinical significance of silent myocardial ischemia (SMI) in individual patient groups. It discusses the problem of SMI in acute coronary syndrome (ACS), the possible causes of SMI and the specific features of its diagnosis. It also indicates that there is a ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:10.17116/terarkh201587997-101
更新日期:2015-01-01 00:00:00
abstract::Echography was used to study 28 parameters reflecting the structure and function of the left ventricle in 148 patients suffering from stages I and II arterial hypertension. A close correlation was established between arterial hypertension standing and the thickness of the interventricular septum in the systole and dia...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:AIM:To study morphoimmunological and clinical features of primary mediastinal large B-cell lymphoma (PMLBCL). MATERIAL AND METHODS:We analysed the results of biopsy material study and treatment of 86 PMLBCL patients, effects of different factors on the disease prognosis, efficacy of some therapeutic programs and overa...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract::Peripheral blood erythrocytes of patients with bronchial asthma (BA) and preasthma (PA) were investigated using the following methods: 1) the radiochemical method--the level of specific binding of beta-adrenergic ligands; 2) direct erythrocytometry--erythrocyte diameter; 3) the cytochemical method (paraldehyde fuchsin...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::The review presents an update on the determination of the causes and mechanisms of acute and chronic cough. It assesses the concept of productive and non-productive cough (acute cough, chronic cough), its duration in different diseases of the lung, upper and lower respiratory tract, pulmonary embolism, gastroesophagea...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:
更新日期:2012-01-01 00:00:00
abstract::The paper is concerned with the results and analysis of transesophageal electrocardiostimulation in 383 patients before and in hospital over 6 years for urgent therapy of brady- and tachyarrhythmias. The method was assessed using a simple, recoverable and effective first aid element in combined resuscitation measures,...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:AIM:Investigation of postaggressive reaction of metabolism on intermitten hemofiltration (IHF) in patients with acute renal failure (ARF). The speed of generation of urea, creatinine and oligopeptides was estimated in the course of (IHF) and in interval between the procedures. Hormonal stress was evaluated by concentra...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::As many as 195 patients with rheumatoid arthritis (RA) were examined for the clinical characteristics of the disease course depending on the presence or lack of antibodies to DNA or of antinuclear factor (ANF). Provided the patients' blood serum contained antibodies to DNA and ANF, RA was noted to run a graver course ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::An echographic study of the kidneys was performed in 24 men with proved gout aged 40 to 50 and a disease duration of 10-20 yrs. On the basis of case history data urolithiasis was noted in 4 patients, whereas by echodiagnosis it was found in 12. Cysts were detected in 6 patients with gout complicated by urolithiasis an...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:AIM:To analyse lethal outcomes in patients with newly-diagnosed respiratory tuberculosis comorbid with HIV-infection depending on initial count of CD4+ lymphocytes. MATERIAL AND METHODS:Of 304 HIV patients with newly-diagnosed tuberculosis treated in Moscow Tubercusis Hospital N 7 in 2006-2010, 40 (13.2%) patients die...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00