Lisova A. Clinical and pathogenetic characteristics and optimization of treatment of patients with chronic glomerulonephritis and associated coronary heart disease

The thesis is devoted to the issue of optimizing of the treatment of patients with chronic glomerulonephritis and associated coronary heart disease based on the study of phenotypic and functional properties of monocytes, the levels of MCP-1, VE-cadherin, structural and functional parameters of peripheral arteries and their role in the pathogenesis and progression of co-morbidity. The important role of monocytes, the levels of MCP-1, VE-cadherin in the clinical course and progression of chronic glomerulonephritis and associated coro-nary artery disease has been proved. It has been shown that the development of coronary heart disease is accompanied by changes in structural and functional pa-rameters of peripheral arteries. The disturbances of the functional and phenotypic parameters of monocytes, the levels of MCP-1, cellular immunity indexes, circulatory immune complexes and its fraction composition, phagocytic activity of monocytes indexes, cytokine blood profile indexes and VE-cadherin which play a potential role in the develop-ment and progression of coronary artery disease in patients with chronic glomeru-lonephritis were revealed. Treatment of patients with chronic glomerulonephritis associated with coronary heart disease with L-arginine in a daily dose of 4.2 g reduced proteinuria, decreased blood pressure, improved the health status of patients, corrected functional parameters of monocytes, reduced excessive production of MHP-1 and VE-cadherin and reduced cardiovascular complications in these patients via reducing nitric oxide deficiency in the kidney tissue and bloodstream.