Gavrylyuk V. The neuroendocrine mechanisms of nephropathy in hypertensive patients with obesity and their correction.

The work is devoted the improvement early diagnosis of nephropathy by establishing relationships of neuroendocrine factors, indicators of renal function and intrarenal hemodynamics in patients with arterial hypertension and obesity. Proved that the increase in body weight in patients with hypertension associated with low physical activity, family history of hypertension and obesity, heredity, eating disorders, increased daily albuminuria and decreased renal functional reserve. The early marker of kidney disease in hypertensive patients with obesity is the resistivity index of intrarenal arteries, which rise more than 0.50 indicates a decline in renal functional reserve. It is proved that the mechanisms of nephropathy in hypertensive patients with obesity and hyperinsulinemia, hyperleptinemiya involved, as evidenced by a close relationship of blood levels of insulin and leptin, daily albuminuria and insulin levels to the magnitude of renal functional reserve. The greater antihypertensive and nephroprotective efficiency of complex treatment of hypertensive patients with stage II obesity I or II is installed using in the treatment angiotensin-converting enzyme inhibitor or angiotensin II receptor antagonist while reducing body mass index by 5% or more.