Ovska O. Feature of arterial hypertension, bone and mineral disorders in patients with chronic kidney disease who are treated by program hemodialysis

The thesis deals with the peculiarities of clinical course of hypertension, cardiovascular remodeling, bone and mineral disorders and plasma level of osteopontin in patients with chronic kidney disease (CKD) receiving program hemodialysis. Found that in patients with CKD 48-hour blood pressure monitoring has higher diagnostic value in the verification of hypertension in comparison with "office" measurement. The majority of patients with end-stage CKD on hemodialysis type of pathological LVH is concentric geometry. Patients with СKD characterized by severe secondary hyperparathyroidism, hyperphosphatemia and increased calcium phosphorus product. Revealed that plasma level of osteopontin increase with worsening renal function and reaches a maximum in patients on hemodialysis, as an carotid intima-media thikness. It is proved that the 12-week treatment candesartan in patients with 5 stage CKD on hemodialysis with hypertension results in achieving target blood pressure levels according to the 48-hour monitoring in 66.0% of patients, improves circadian BP profile probably reduces the intensity of cardiovascular remodeling and reduces plasma concentrations of osteopontin. Osteopontin defined as a communications link of bone and mineral disorders and cardiovascular remodeling in patients with renal replacement therapy by hemodialysis.