2016


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2016/№2

Do levels of C-reactive protein and blood protein spectrum components influence the clinical course of chronic heart failure combined with chronic kidney disease?

Nasybullina A. A.1, Bulashova O. V.1, Khazova E. V.1, Gazizyanova V. M.1, Nasybullina N. Kh.2, Malkova M. I.1
1 – State Budgetary Educational Institution, “Kazan State Medical University” of the RF Ministry of Health Care, Butlerova 49, Kazan 420012
2 – Treatment and Prophylaxis Institution, “Occupational Health Facility of the Open Join-Stock Company, “Tatneft” and the city of Almetjevsk”, Radishcheva 67, Almetjevsk 423450, the Republic of Tatarstan

Keywords: CHF, chronic kidney disease, biomarkers

DOI: 10.18087/rhfj.2016.2.2186

Background. At the present time, several hypotheses exist, which explain causes for HF progression. The same is also true for chronic kidney disease (CKD). Aim. To study systemic inflammation markers in patients with CHF combined with CKD. Materials and methods. This open-label, prospective study included 188 patients with HF and kidney disease, including a reference group (76 patients) with CHF without kidney disease. Mean age of all patients was 66.8±10.1, and CHF duration was 7.8±4.7 years. Approximately 90 % of patients had IHD; 70 % of patients had AH. Distribution of CHF FCs was comparable between the groups. Causes for kidney abnormality included HF (52.7 %) and chronic inflammatory kidney disease (47.3 %). Glomerular filtration rate (GFR) was calculated using MDRD and CKD-EPI formulas; CKD was diagnosed according to NKF, KDIGO (2005). Measured parameters included high-sensitivity C-reactive protein (CRP) and serum protein fractions, daily protein excretion (DPE), and the urinary albumin / creatinine ratio. Results. GFR was 71.1±11.7 ml / min / 1.73 m2 for patients of the reference group and 51.5±19.1 ml / min / 1.73 m2 for patients with CHF and CKD. In patients with CHF and CKD, daily protein excretion was 10 times higher than in the reference group, which was confirmed by a higher urinary albumin / creatinine ratio. In cases where HF was associated with kidney damage, levels of blood CRP and γ-globulin were increased while blood levels of total protein and albumin were decreased compared to the same parameters in patients with HF alone. Conclusion. The study results showed changes in levels of CRP and serum protein fractions in patients with CHF combined with CKD, which predicted unfavorable course of these diseases.
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Nasybullina A. A., Bulashova O. V., Khazova E. V., Gazizyanova V. M., Nasybullina N. Kh., Malkova M. I. Do levels of C-reactive protein and blood protein spectrum components influence the clinical course of chronic heart failure combined with chronic kidney disease? Russian Heart Failure Journal. 2016;17 (2):75–81

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