Dubovyk M. Anemia and its correction effect on the structural and functional changes of left ventricular in patients with diabetic nephropathy on peritoneal dialysis.

The thesis is dedicated to improving the treatment of anemia in patients with chronic kidney disease due to diabetes by receiving renal replacement therapy using peritoneal dialysis based on the study of structural and functional changes of the left ventricular, through the use of erythropoietin. The work investigated the relationship between hemoglobin concentration and indicators of structural and functional state of the heart. It is established that anemia increases left ventricular remodeling in patients with diabetes on peritoneal dialysis. The increase of the frequency of eccentric left ventricular hypertrophy and types of adverse violation transmitral blood flow - pseudonormal and restrictive, in patients with low hemoglobin (<85 g/l) are marked. The efficacy of erythropoietin-stimulative agents for 48 weeks in patients with diabetic nephropathy and anemic syndrome on peritoneal dialysis is proven. It is found that correcting erythropoietin therapy leads not only to normalize the basic hematological parameters, but also to a significant reduction in the size and volume of the left ventricular cavity, thereby improves its systolic and diastolic functions. These results suggest normalizing effect of correction of anemia to increase blood flow in the vessels of the peritoneum, leading to improved adequacy of peritoneal dialysis.