Mykhajlova Y. Association of immune inflammation and kidney dysfunction in chronic heart failure in patients with ischemic heart disease accompanied by chronic pyelonephritis.

The thesis deals with solving the problem of increasing the efficiency of early diagnosis and treatment of renal dysfunction in patients with ischemic heart disease (IHD) and chronic heart failure (CHF) accompanied by initial stages of chronic pyelonephritis (CР). We have studied the levels of glomerular (creatinine, glomerular filtration rate (GFR), cystatin C) and tubular (urine-?2-microglobuline) markers of the kidney function, markers of immune inflammation - tumor necrosis factor - ? (TNF-?) and transforming growth factor -?1 (TGF-?1), the state of cardiac hemodynamics, the efficiency of quercetin in addition to standard therapy. There have been conducted a comparative analysis of these parameters in general groups and by dividing the groups by CHF functional class, by the presence of left ventricular hypertrophy, by the state of systolic function of the myocardium and by the level of GFR. It has been shown that the patients with IHD and CHF accompanied by CP demonstrate the potentiation of glomerular-tubular disorders of the kidneys, further activation of TNF-? and TGF-?1, prevalence of cardiac hypertrophy and diastolic dysfunction in comparison with IHD and CHF without CP. These results have provided evidence that CP even in clinical and laboratory remission stage in patients with IHD and CHF potentiates renal impairment and activity of immune inflammation. It affects the structural and functional characteristics of the myocardium (left ventricular hypertrophy, diastolic dysfunction). The inclusion of quercetin into the standard therapy has been shown to result in immune modulatory, nephroprotective, cardioprotective effects, especially in patients with IHD and CHF without CP.