Pererva L. Endothelial dysfunction in the patients with diabetic nephropathy.

3.Object of the study: Diabetes mellitus type 1 complicated with different stages of diabetic nephropathy and without diabetic nephropathy. Purpose of the study: To improve diagnostics and forecasting of DN course on the base of ET-1 and FN research as risk factors of progressing pathological process in kidneys. Methods of research: General clinical laboratory and instrumental studies, method of immunoenzyme analysis, photometry method, quantitative colorimetry and photoelectrocalorimentry methods, investigation of eye-bottom vessels by means of ophthalmoscope. Theoretical and practical results: The obtained findings allow to determine the markers of fast DN progressing owind to development of fibroblastic process in kidneys (reduction of ET-1 content in blood simultaneously with increase of fibronectine excretion with urine), whith can be used in screening of diabetic microangiopathy. The investigation of ET-1 increase degree in blood, and also FN degree in blood and urine allows to single out groupsof patients with increased risk of kidneys lesion, to estimate the speed of its progressing, to substantiate the forecast of sickness. That will assist to opportune and adequate correction of therapy, to extension of predialysis period and to improvement life quality of patients with diabetic nephropathy. Novelty: The obtained results allow to determine the speed of sclerotic process progressing in kidneys (relative accumulation of FN content in blood, increased FN excretion with urine) and may be used in investigation of patients with diabetic nephropathy. We established increase of ET-1 content in blood of patients with diabetic nephropathy at all stages of its development, most expressed at the initial stages of kidneys lesion. It is proved that increase of ET-1 content in blood and accumulation of FN excretion with urine reflects the severity of DN course. Progressing changes of theese indicators stand for steady development of sclerotic alterations in kidneys. FN excretion with urine achieves maximum indicators in the case of development of chronic renal failure that means of damage of tubulointerstitial structures of kidneys. Degree of introduction: the results of investigation are introduced into the clinical practice of Nephrology Department of Kharkiv Regional Clinical center of Urology and Nephrology, of City Nephrology Consulting-Room, endocrinology department of Clinical Hospital N2, endocrinology department of Regional Clinical Hospital, nephrology department of Kharkiv Clinical Hospital N26. Sphere of application: medicine, internal diseases, nephrology, endocrynology.