Аvdeyeva O. The role of endothelin-1 and fibronectin in progression of chronic glomerulonephritis.

Object of the study: patients with chronic glomerulonephritis. Purpose of the study: To improve the diagnosis and prognosis of chronic glomerulonephritis (CGN) basing on the study of endothelin-1 (ET-1) and fibronectin (Fn) as risk factors of renal inflammatory process progression. Methods of the study: General clinical methods of blood and urine analysis, biochemical blood analysis, clinical instrumental study were used. Endothelium state was assessed according to blood ET-1 concentration determined by radioimmune assay, Fn amount was evaluated using immunoenzyme analysis. Practical significance of the obtained results: The findings of the research allow to recommend estimation of ET-1 and Fn amount during dynamic observation of the patients with chronic glomerulonephritis as criteria for prognosis of the disease course. Reduction in blood ET-1 and Fn amount is a marker of the progress of fibroplastic processes in the nephrons and is an indication to the choice of timely optimum correction of homeostatic disorders (administration of low protein diet, enterosorption, ACE inhibitors even when clinical signs of chronic renal failure are absent). Novelty of the obtained results: Severity of the inflammation in the nephrons and development of sclerotic changes were established to be associated with the state of the endothelium and extracellular matrix. For the first time, increase in blood ET-1 amount in patients with CGN with sufficient function of the kidneys and reduction of this value in chronic renal failure was determined. Correlation between blood ET-1 and Fn levels in CGN was determined, presence of association between ET-1, Fn and other factors of the disease progress (arterial pressure, proteinuria, hematuria, blood lipid amount) was shown. Increase in blood Et-1 and Fn levels was proved to reflect severity of the inflammation in the nephrons. Progressive reduction in these values suggests development of fibroplastic sclerotic changes in the kidneys. Degree of introduction: The results of the research are used in the work of hospitals and scientific institutions of Kharkiv (Regional Clinical Center of Urology and Nephrology, Research Institute of Therapy of Academy of Medical Sciences of Ukraine), and Kharkiv region (Krasnograd Central District Hospital) and Donetsk (Regional Clinical Medical Association). Theoretical and practical results are used in teaching process at therapy departments of Kharkiv State Medical University and Donetsk State Medical University. Area of application: medicine, therapy