Bezrodnyy V. Influence of antihypertensive drugs of different classes on the renal function in patients essential hypertension with hypertensive nephropathy.

Dissertation is dedicated to improvement of the treatment in essential hypertension patients with hypertensive nephropathy by means of factors detection, which have negative influence on renal function and optimization in its treatment with different classes of antihypertensive drugs depending on renal function at baseline, ambulatory blood pressure, carbohydrate and lipid metabolism. We revealed that decline in glomerular filtration rate (GFR) in hypertensive kidney damage had significant reverse correlation with insulin resistance, microalbuminuria, C-reactive protein (CRP), total cholesterol, low density lipoproteins, triglycerides, activation of system inflammation and adverse ambulatory blood pressure parameters (high systolic blood pressure variability, "non-dipper" status, high absolute values of systolic and diastolic blood pressure). It is shown that antihypertensive therapy during three months with losartan, lercanidipine and perindopril had significant nephroprotective effect - increasing of GFR and reduction of microalbuminuria. Nephroprotective effect is significantly higher in hypertensive patients with "non-dipper" comparing to "dipper" status. Losartan and perindopril caused significant reduction of nonspecific systemic inflammation activity, at the same time we detected only trend of its reduction with lercanidipine. Antihypertensive treatment with losartan, lercanidipine and perindopril induced amelioration of insulin sensitivity of tissues.