The dissertation is devoted to the non-invasive diagnosis of coronary artery disease progression in CKD patients on PD. In the current study the "traditional" factors of progression of coronary artery disease were examined: hemodynamic, including the remodeling of the left ventricular myocardium, metabolic, which are characteristic of PD that include dyslipidemia and violations of calcium-phosphorus metabolism, and immunological, as a manifestation of systemic inflammatory reaction initiated by the including endothelial dysfunction. The latter include: interleukins (IL-1?, TNF-?, IL-8) and acute phase proteins associated with lipoprotein (CRP and SAA). 114 patients with CKD on PD were examined, which, depending on the progression of coronary artery disease were divided into clinical groups: 1 - stable angina (n = 5), 2 - myocardial infarction during the study (n = 5), 3 - patients with silent myocardial ischemia (n = 35), 4 - patients without evidence of coronary artery disease (a control group) (n = 28), 5 - IDKMP patients (n = 41). Mean age was 47,9±1,2 g (under 50 years), among them men - 64 (56%), women - 50 (44%). The disease entity of the majority of patients was chronic glomerulonephritis, statistically significant difference between the nosological groups was not found. By age and duration of stay in PD patients from the comparison group were younger and less long were treated on PD. The most senior in age and duration of stay in PD patients were suffering from stable angina. It was found that in patients with CKD on PD most often have silent myocardial ischemia. In order to detect "silent" myocardial ischemia in these patients as in the general population, ECG cardiac stress test has been used, and if there are no contraindications to its performance - dopplerechocardiographic study with the calculation an index of systolic thickening of the left ventricular myocardium, considering the result below 33 % sign of myocardial ischemia has been applied. Hemodynamic and metabolic factors associated with the development of angina in patients on peritoneal dialysis were: higher mean arterial blood pressure, blood clots and violations of calcium-phosphorus metabolism. For myocardial ischemia dyslipidemia (increased LPVLD and hypertriglyceridemia), anemia, a high index of left ventricular mass and high standardised protein catabolic rate were more typical. Persistent hypoalbuminemia in PD patients was peculiar to IDCMP and heart failure. Proinflammatory interleukins (TNF-?, IL-1?), and acute phase proteins (fibrinogen and CRP) were determined as predictors of acute coronary risk (acute myocardial infarction), whereas IL-8, which have fibrosing characteristics and acute phase protein (serum amyloid A) were associated with progression IDCMP in PD patients. Prediction of acute coronary risks had a higher degree of confidence based on identified mitral valve calcification and concentric left ventricular hypertrophy with dopplerechocardiographic study and progression IDCMP - with detection of fibrosis of the aorta and cardiac structures. According to the results of analysis of the multivariable process of progression of coronary artery disease in patients with CKD on PD and using the statistical program SPSS 19,0 we have derived mathematical models that predict the various options for coronary artery disease progression in CKD patients on PD, identify groups of coronary risk of these patients for coronary angiography to prevent cardiac mortality and to improve the quality of life of patients on continuous ambulatory peritoneal dialysis.
