Neuroendocrine mechanisms of development of nephropathy of patients with an essential hypertension and obesity.

Prof. М.N. Kochyeva, as. В.А. Gavrilyk. Kharkov Medical Academy of Postgraduate Education.

Arterial hypertension is the second largest (after diabetes) is a risk factor for chronic renal failure. Hypertensive nephropathy is diagnosed in 4-15% of patients with various stages of hypertension. One of the earliest markers of renal function is microalbuminuria. Violations of renal hemodynamics with subsequent appearance of intraglomerular hypertension and glomerular hyperperfusion say about stage development of nephropathy before albuminuria — step hyperfltration. Among those who are overweight, in particular obesity, hypertension is diagnosed in 5-6 times more likely than those with normal weight. One of the most important targets, the targeted for obesity are kidney failure which occurs with the participation of several hormones, growth factors and proinfammatory cytokines, including components of the renin-angiotensin system, leptin, adiponectin, resistin, interleukin-6, produced by visceral (brown) adipose tissue. Allocate the basic mechanisms of renal disease in obesity: endothelial dysfunction, hyperinsulinemia, olygonephronia. Antihypertensive drugs of choice in patients with hypertension and obesity are defined as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor antagonists II (ARA II).

Key Words: arterial hypertension, obesity, nephropathy, hyperfltration, microalbuminuria, angiotensinconverting enzyme inhibitor, angiotensin II receptor antagonist.

Kochyeva МN, Gavrilyk ВА. [Neuroendocrine mechanisms of development of nephropathy of patients with an essential hypertension and obesity]. Shidnoevr. z. vnutr. simejnoi med. 2014;1:43-50. Russian.

http://dx.doi.org/10.15407/internalmed2014.01.043

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